McKay Katherine J, Ferguson Patricia E, Shaban Ramon Z
Infection Prevention and Control, Eastern Health, Box Hill, Victoria, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia.
Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Center for Infectious Diseases and Microbiology, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia.
Am J Infect Control. 2021 Nov;49(11):1384-1391. doi: 10.1016/j.ajic.2021.04.081. Epub 2021 May 1.
Direct observation is the gold standard method for measuring hand hygiene compliance but its utility is increasingly being questioned. Various alternative electronic methods have been proposed, yet there is a paucity of research examining the use of these according to the World Health Organization's (WHO) '5 Moments for Hand Hygiene'. As a part of the process of developing a video-based monitoring system (VMS) capable of measuring hand hygiene compliance against the 5 moments criteria this paper reports methodological and technical issues that might arise from the use of a VMS for auditing in clinical practice.
In-depth semi-structured interviews were conducted with 27 Australian content experts in hand hygiene auditing and infection prevention to explore their responses to proposed VMS auditing approaches. Transcripts were analyzed using thematic and content analysis.
Technical and methodological considerations for the use of VMS were interrelated and included concerns surrounding privacy, footage security, fears of surveillance and the potential for medico-legal consequences. Additionally, possible detrimental impacts on healthcare worker (HCW) -patient relationships, issues of cost versus benefits, HCW and patient safety and changes to feedback were also identified.
The primary methodological and technical issues to overcome in order to implement VMS for hand hygiene auditing in clinical practice, centered upon issues of acceptability to patients and health professionals, privacy, consent and liability.
COREQ.
直接观察是衡量手部卫生依从性的金标准方法，但其效用正日益受到质疑。人们提出了各种替代电子方法，但根据世界卫生组织（WHO）的“手部卫生五个时刻”来研究这些方法使用情况的研究却很少。作为开发一种能够根据五个时刻标准测量手部卫生依从性的基于视频的监测系统（VMS）过程的一部分，本文报告了在临床实践中使用VMS进行审核可能出现的方法和技术问题。
对27名澳大利亚手部卫生审核和感染预防方面的内容专家进行了深入的半结构化访谈，以探讨他们对提议的VMS审核方法的反应。使用主题分析和内容分析对访谈记录进行了分析。
使用VMS的技术和方法考虑因素相互关联，包括对隐私、录像安全、监控恐惧以及潜在的医疗法律后果的担忧。此外，还确定了对医护人员与患者关系可能产生的不利影响、成本效益问题、医护人员和患者安全以及反馈变化。
为在临床实践中实施VMS进行手部卫生审核而要克服的主要方法和技术问题，集中在患者和卫生专业人员的可接受性、隐私、同意和责任等问题上。
COREQ。
