The power of feedback: Implementing a comprehensive hand hygiene observer program

Wilson, Kimberly; Satchell, Lauren; Smathers, Sarah; Goff, Lauren F. Le; Sammons, Julia Shaklee; Coffin, Susan

doi:10.1016/j.ajic.2022.06.003

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…This supports the findings of several other studies, including systematic reviews on the validity of self-reported HHC [3,6,24]. In addition, in recent years, HCWs have received direct feedback on their hand hygiene behaviour after hand hygiene observations more often [12,25,26]. Despite insight into their own behaviours, HCWs still usually overestimate their own abilities compared with the results of direct objective observations [6].…”

Section: Discussionsupporting

confidence: 84%

Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals

Dijk¹,

Nieboer²,

Vos³

et al. 2023

Journal of Hospital Infection

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Section: Discussionsupporting

confidence: 84%

Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals

Dijk¹,

Nieboer²,

Vos³

et al. 2023

Journal of Hospital Infection

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“…In line with another recent study,29 the introduction of overt observations is a key factor in keeping the focus on HH and enhancing patient safety. Overt observations facilitated communication between the HH program and HCWs to better understand workflow and educate staff on HH opportunities 29. Birnbach et al30 showed that, even after intensive HH education, medical student HH compliance remained low.…”

Section: Discussionsupporting

confidence: 76%

“…Following the Improve and Control 1 phases, overt observations (JIT coaching) were conducted. In line with another recent study,29 the introduction of overt observations is a key factor in keeping the focus on HH and enhancing patient safety. Overt observations facilitated communication between the HH program and HCWs to better understand workflow and educate staff on HH opportunities 29.…”

Section: Discussionsupporting

confidence: 76%

“…Overt observations facilitated communication between the HH program and HCWs to better understand workflow and educate staff on HH opportunities. 29 Birnbach et al 30 showed that, even after intensive HH education, medical student HH compliance remained low. The TST methodology enabled us to switch the focus from a staff educational only approach, to improving processes (eg, PPE donning and doffing) and environmental factors (eg, hand sanitizer dispensers at the right place, glove dispenser relocation).…”

Section: Discussionmentioning

confidence: 99%

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Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool

Ragonese

Mularoni

Valeri

et al. 2022

Journal of Nursing Care Quality

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Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide urgent health problem. Hand hygiene (HH) is an effective intervention to reduce the spread of CRE.Local Problem: In 2017, an increase in the rate of health care-associated (HA) CRE colonization was observed in a large multiorgan transplant center in Italy. This study aimed to reduce the HA-CRE colonization rates by improving HH compliance. Methods: A pre-/post-intervention project was conducted from November 2017 through December 2020. Interventions:The DMAIC (Define, Measure, Analyze, Improve, and Control) framework was used to implement the HH Targeted Solution Tool (TST). Results: Hand hygiene compliance increased from 49% to 76.9% after the Improve phase (P = .0001), and to 81.9% after the second Control phase (P = .0001). The rate of HA-CRE decreased from 24.9% to 5.6% (P = .0001). Conclusions: Using the DMAIC framework to implement the TST can result in significant improvements in HH compliance and HA-CRE colonization rates.

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“…10,25 We believe that moments 2 and 3 were difficult to observe due to the patient privacy arrangements and the architectural features of the ICU. [26][27][28] However, part of our study was performed during the COVID-19 pandemic; it was challenging to employ observers during this unusually critical time in our ICU. 29,30 Another standard method is to monitor HH at entries and exits.…”

Section: Discussionmentioning

confidence: 99%

Comparing human to electronic observers to monitor hand hygiene compliance in an intensive care unit

Casaroto

Generoso

Neto

et al. 2022

ASHE

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Objective: We sought to determine whether an electronic hand hygiene (HH) system could monitor HH compliance at similar rates to direct human observation. Methods: This 4-year proof-of-concept study was conducted in an intensive care unit (ICU) of a private tertiary-care hospital in São Paulo, Brazil, where electronic HH systems were installed in 2 rooms. HH compliance was reported respectively using direct observation and electronic counter devices with an infrared system for detecting HH opportunities. Results: In phase 1, HH compliance by human observers was 56.3% (564 of 1,001 opportunities), while HH compliance detected by the electronic observer was 51.0% (515 of 1,010 opportunities). In phase 2, human observers registered 484 HH opportunities with a HH compliance rate of 64.7% (313 of 484) versus 70.6% (346 of 490) simultaneously detected by the electronic system. In addition, an enhanced HH electronic system monitored activity 24 hours per day and HH compliance without the presence of a human observer was 40.3% (10,642 of 26,421 opportunities), providing evidence for the Hawthorne effect. Conclusions: The electronic HH monitoring system had good correlation with human HH observation, but compliance was remarkably lower when human observers were not present due to the Hawthorne effect (25%–30% absolute difference). Electronic monitoring systems can replace direct observation and can markedly reduce the Hawthorne effect.

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The power of feedback: Implementing a comprehensive hand hygiene observer program

Cited by 5 publications

References 16 publications

Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals

Validity of self-reported compliance and behavioural determinants of observed compliance: an application of the COM-B hand hygiene questionnaire in nine Dutch hospitals

Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool

Comparing human to electronic observers to monitor hand hygiene compliance in an intensive care unit

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