Impact of a simulation-based training in hand hygiene with alcohol-based hand rub in emergency departments

Abstract

BackgroundHand hygiene is the primary measure for reducing nosocomial infections based on 7 steps recommended by the WHO. The aim of this study was to assess the duration and the quality of hand hygiene before and after simulation-based training (SBT).MethodsThe study took place in a University Hospital Pediatric Department among its residents and nurses. In assessment A, 10 hand-rubbing procedures per participant during a work day were scored by observers using a validated, anatomically based assessment scale. Two weeks later, all participants received a didactic course and SBT, followed 1 month later by assessment B, observation of 10 hand-rubbing procedures. Assessments were performed by 2 independent observers. Before-and-after testing was used to evaluate the demonstration of theoretical knowledge.ResultsIn total, 22 participants were included, for whom 438 hand hygiene procedures were assessed: 218 for assessment A and 220 for assessment B. The duration of hand rubbing increased from 31.16 seconds in assessment A to 35.75 seconds in assessment B (P=.04). In assessment A, participants averaged 6.33 steps, and in assessment B, participants averaged 6.03 steps (difference not significant). Significant improvement in scores was observed between assessments A and B, except for the dorsal side of the right hand. The wrist and interdigital areas were the least-cleaned zones. A difference between assessments A and B was observed for nail varnish (P=.003) but not for long nails or jewelry. Theoretical scores increased from 2.83 to 4.29 (scale of 0–5; P<.001).ConclusionThis study revealed that an optimal number of steps were performed during hand-rubbing procedures and that SBT improved the duration and quality of hand hygiene, except for the dorsal right side. Emphasis should be placed on the specific hand areas that remained unclean after regular hand-rubbing procedures.

Cross-Sectional Study to Evaluate Knowledge on Hand Hygiene in a Pandemic Context with SARS-CoV-2

“…This result is in contrast to a study conducted in Pakistan, which reported that only 20% of respondents were aware of this issue [36]. A prospective study in an intensive-care and pediatrics unit in France showed that only a third of students knew the appropriate duration of hand rubbing before theoretical training and, furthermore, the duration of hand decontamination was found to decrease significantly during repeated procedures [37].…”

The role of simulation-based training in healthcare-associated infection (HAI) prevention

“…Furthermore, 3 studies focused on SBT for hand hygiene using the application of fluorescent alcohol-based hand rub under ultraviolet C light with all studies demonstrating improvement in complete application of alcohol hand rub. [7][8][9] In addition, 3 studies used SBT to recreate clinical scenarios pertaining to suspected Ebola and severe acute respiratory syndrome (SARS) cases [11][12][13] with identification of errors in infection control measures, 11 and improvement in both postintervention scores 12 and learners' sense of confidence. 13 Also, 13 studies utilized SBT for CLABSI prevention, and 10 studies focused on aseptic technique pertaining to central venous catheter (CVC) insertion [17][18][19][20][21][22][23][24][25][26] with improvement in sterile technique [20][21][22][23][24][25][26][27] and CLABSI rate.…”

Hand hygiene practices for prevention of health care-associated infections associated with admitted infectious patients in the emergency department: a systematic review

“…Posters were utilised by two authors (10%) [ 25 , 38 ]. Evaluation and Questionnaires were reported in three articles (15%) [ 30 , 34 , 37 ]. Feedback approaches were associated with three publications (15%) [ 25 , 37 , 38 ].…”