Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Department of Quality and Education, Infection Control Unit, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark.
Am J Infect Control. 2021 Jun;49(6):733-739. doi: 10.1016/j.ajic.2020.11.007. Epub 2020 Nov 10.
Evidence-based practices to increase hand hygiene compliance (HHC) among health care workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC.
During this 14-month prospective, observational study, an automated monitoring system was implemented in a 29-bed surgical ward. Hand hygiene opportunities and alcohol-based hand rubbing events were measured in patient and working rooms (medication, utility, storerooms, toilets). We compared baseline HHC of health care workers across periods with light-guided nudging from sensors on dispensers and data-driven performance feedback (multimodal strategy) using the Student's t test.
The doctors (n = 10) significantly increased their HHC in patient rooms (16% vs 42%, P< .0001) and working rooms (24% vs 78%, P= .0006) when using the multimodal strategy. The nurses (n = 26) also increased their HHC significantly from baseline in both patient rooms (27% vs 43%, P = .0005) and working rooms (39% vs 64%, P< .0001). The nurses (n = 9), who subsequently received individual performance feedback, further increased HHC, compared with the period when they received group performance feedback (patient rooms: 43% vs 55%, P< .0001 and working rooms: 64% vs 80%, P< .0001).
HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system.
有证据表明，采取循证实践可以提高医护人员的手卫生依从性（HHC）。本研究旨在调查多模式策略对 HHC 的影响。
在这项为期 14 个月的前瞻性观察研究中，我们在一个 29 张床位的外科病房中实施了自动监测系统。在患者和工作间（配药室、公用室、储藏室、厕所）中测量了手卫生机会和使用酒精搓手液的事件。我们使用学生 t 检验比较了在使用基于传感器的灯光提示和基于数据的绩效反馈（多模式策略）的 dispensers 时，医护人员在基线期的 HHC。
当使用多模式策略时，医生（n=10）在患者房间（16% vs 42%，P<.0001）和工作间（24% vs 78%，P=.0006）的 HHC 显著增加。护士（n=26）在患者房间（27% vs 43%，P =.0005）和工作间（39% vs 64%，P<.0001）的 HHC 也从基线显著增加。在收到个人绩效反馈后，与收到群体绩效反馈相比，护士（n=9）的 HHC 进一步增加（患者房间：43% vs 55%，P<.0001和工作间：64% vs 80%，P<.0001）。
使用自动手卫生系统进行基于灯光提示和基于数据的绩效反馈，可以显著提高医生和护士的 HHC。
