Evaluating the effect of electronic monitoring and feedback on hand cream use in healthcare workers: Healthy Hands Project

Abstract

Background Healthcare workers (HCWs) are at high risk of developing hand dermatitis (HD). Current guidelines on HD prevention recommend the use of emollients; however, in practice, adherence is poor. Objective To assess whether the provision of creams, electronic monitoring and feedback on cream consumption can improve skin care in HCWs. Methods A cluster randomized controlled trial was conducted on 19 academic hospital wards, including 501 HCWs, for 12 months. The intervention wards ( n = 9; 285 HCWs) were provided with hand cream dispensers equipped with an electronic system to monitor use, which was regularly communicated to the HCWs by the use of posters. The process outcomes were self‐reported cream consumption in both groups, and electronically measured consumption per ward in the intervention group (IG) vs the control group (CG). Results Self‐reported cream use at follow‐up was significantly higher in the IG than in the CG, before (odds ratio [OR] 2.27; 95%CI: 1.29‐3.97; P = 0.004) and during (OR 3.30; 95%CI: 1.80‐6.06, P < 0.001) the shift, whereas at baseline there was no difference between the groups. In the IG, electronically measured cream use was, on average, 0.4 events per shift per HCW. Conclusion The intervention improved hand cream use, and may therefore be considered as a practical strategy to promote skin care in HCWs. Notwithstanding this, the application frequency remained lower than recommended in the present study and current guidelines.

Effectiveness of a skin care programme for the prevention of contact dermatitis in healthcare workers (the Healthy Hands Project): A single‐centre, cluster randomized controlled trial

“…This intervention was reported to improve hand cream use. 28 However, the IG did not show significantly better improvement in the primary outcome (ΔHECSI) and secondary outcome (ΔNMF) than the CG. Notwithstanding this, the intervention showed overall positive effects on the severity of HD symptoms, supporting the benefits of creams in the workplace, in particular in HCWs with mild HD.…”

“…There was no significant difference between the IG and the CG. The electronically measured cream use in the IG was, on average, 0.4 application events per HCW per shift during the trial …”

“…The electronically measured cream use in the IG was, on average, 0.4 application events per HCW per shift during the trial. 28…”

Hand eczema: treatment

“…83 Integrated care by a multidisciplinary teams, combining clinical and occupational care to optimize treatment, and the patient's quality of life and social functioning will improve outcomes. Provision of creams, electronic monitoring and feedback on cream consumption may be used to improve adherence to topical therapy.…”

“…Provision of creams, electronic monitoring and feedback on cream consumption may be used to improve adherence to topical therapy. 83 Integrated care by a multidisciplinary teams, combining clinical and occupational care to optimize treatment, and the patient's quality of life and social functioning will improve outcomes. 84 Specific teaching interventions have been developed for the management of patients with hand eczema that should be incorporated into therapeutic concepts.…”