Department of Epidemiology, North Shore University Hospital, Manhasset, NY, USA.
Clin Infect Dis. 2012 Jan 1;54(1):1-7. doi: 10.1093/cid/cir773. Epub 2011 Nov 21.
Hand hygiene is a key measure in preventing infections. We evaluated healthcare worker (HCW) hand hygiene with the use of remote video auditing with and without feedback.
The study was conducted in an 17-bed intensive care unit from June 2008 through June 2010. We placed cameras with views of every sink and hand sanitizer dispenser to record hand hygiene of HCWs. Sensors in doorways identified when an individual(s) entered/exited. When video auditors observed a HCW performing hand hygiene upon entering/exiting, they assigned a pass; if not, a fail was assigned. Hand hygiene was measured during a 16-week period of remote video auditing without feedback and a 91-week period with feedback of data. Performance feedback was continuously displayed on electronic boards mounted within the hallways, and summary reports were delivered to supervisors by electronic mail.
During the 16-week prefeedback period, hand hygiene rates were less than 10% (3933/60 542) and in the 16-week postfeedback period it was 81.6% (59 627/73 080). The increase was maintained through 75 weeks at 87.9% (262 826/298 860).
The data suggest that remote video auditing combined with feedback produced a significant and sustained improvement in hand hygiene.
手部卫生是预防感染的关键措施。我们评估了使用远程视频审核和无反馈两种方式的医护人员（HCW）手部卫生情况。
该研究于 2008 年 6 月至 2010 年 6 月在一个 17 张床位的重症监护病房进行。我们在每个水槽和洗手液分配器旁边放置了摄像头，以记录 HCW 的手部卫生情况。门道中的传感器可识别个人进出的时间。当视频审核员观察到 HCW 在进出时进行手部卫生时，他们会给予通过；否则，将给予失败。在没有反馈的情况下，进行了为期 16 周的远程视频审核，以及在有反馈的情况下，进行了为期 91 周的数据收集。将绩效反馈持续显示在安装在走廊内的电子板上，并通过电子邮件向主管提供总结报告。
在 16 周的预反馈期内，手部卫生率不到 10%（3933/60542），而在 16 周的反馈期内，手部卫生率为 81.6%（59/73080）。通过 75 周的时间，该比率维持在 87.9%（262/298860）。
数据表明，远程视频审核结合反馈可显著且持续地提高手部卫生水平。
