Dyson Judith, Madeo Maurice
University of Hull, Hull, UK.
Infection Prevention and Control, North Lincolnshire and Goole NHS Foundation Trust, Lincolnshire, UK.
J Infect Prev. 2017 Nov;18(6):278-287. doi: 10.1177/1757177417714045. Epub 2017 Jul 4.
Hand hygiene (HH) prevents the transmission of healthcare-associated infections. Electronic HH monitoring and prompt devices have been developed to overcome problems with monitoring HH and to improve compliance. Devices monitor room entry and exit and soap use through communication between ceiling sensors and badges worn by practitioners and the badges sense alcohol rub.
To investigate (1) the impact of devices on HH compliance, (2) how devices influence behaviour and (3) the experience and opinions of practitioners on the use devices.
HH compliance was monitored (before, during and after system installation) by observations and alcohol rub usage. Compliance during installation was also monitored by the device. Healthcare practitioner interviews (n = 12) explored how the device influenced behaviour and experiences and opinions of wearing the device.
HH compliance improved during the period the device was installed. Practitioners reported the device increased their awareness, enhancing their empathy for patients and encouraged patients and colleagues to prompt when HH was needed. Practitioners' reported better HH, gaming the system and feelings of irritation.
HH prompt and monitoring systems seem to improve compliance but improvements may be undermined by practitioner irritation and system gaming.
手部卫生（HH）可预防医疗相关感染的传播。已开发出电子HH监测和提示设备，以克服HH监测方面的问题并提高依从性。这些设备通过天花板传感器与从业者佩戴的徽章之间的通信来监测房间的进出以及肥皂的使用情况，徽章还能感应酒精擦手液的使用。
调查（1）设备对HH依从性的影响，（2）设备如何影响行为，以及（3）从业者对使用设备的体验和看法。
通过观察和酒精擦手液的使用情况（在系统安装前、安装期间和安装后）监测HH依从性。安装期间的依从性也由该设备进行监测。对12名医疗从业者进行访谈，探讨该设备如何影响行为以及佩戴该设备的体验和看法。
在设备安装期间，HH依从性有所提高。从业者报告称，该设备提高了他们的意识，增强了他们对患者的同理心，并鼓励患者和同事在需要HH时进行提醒。从业者还报告了更好的HH、对系统的投机行为以及烦躁情绪。
HH提示和监测系统似乎能提高依从性，但从业者的烦躁情绪和对系统的投机行为可能会削弱这种改善效果。
