University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye.
University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkiye.
Burns. 2024 Jun;50(5):1307-1314. doi: 10.1016/j.burns.2024.02.020. Epub 2024 Feb 29.
The increasing development of intelligent technologies for hand hygiene (HH) compliance audit has the potential to create an alternative to direct observation (DO), which is still considered the gold standard but has disadvantages such as lack of standardized monitoring practices, Hawthorne effect, insufficient sample size, and time/resource consumption. We aimed to share our preliminary results on the impacts of intelligent monitoring technology installation (IMTI) and additional modalities on healthcare workers' (HCWs') HH compliance in a Burn Center, according to the "5 Moments of HH" concept defined by the World Health Organization (WHO).
A quasi-experimental longitudinal trial was conducted over eleven months.The first phase of the three-stage study evaluated basic HH compliances obtained by DO. The system-defined HH performances, which IMTI recorded, were assessed in the second phase. Finally, the effect of IMTI and additional modalities was determined in the third stage.
15202 HH events were performed by 41 HCWs, and a total of 20095 HH opportunities were observed. Four hundred fifty-five opportunities were in the preinstallation phase, and 19640 were during the total post-installation period. IMTIdefined performance rates in both Phase 2 (71.2%) and Phase 3 (80.5%) were generally considerably higher than HH compliances obtained from DO (58.5%). Nurses, physical therapy /anesthesia technicians, and housekeeping personnel showed significant increases, which was insignificant in physicians in phase 2. Meanwhile, a sustained increase was observed regarding IMTI and additional modalities of HH compliance of all HCWs in Phase 3.
IMTI has significantly increased HH performance rates. Furthermore, combining the IMTI with additional modalities as components of a multimodal strategy recommended by WHO appears to affect the sustainability of the increasing trend of HCWs' HH compliance.
智能手卫生（HH）依从性审核技术的不断发展，有可能替代直接观察（DO），后者虽然仍被视为金标准，但存在缺乏标准化监测实践、霍桑效应、样本量不足以及耗费时间/资源等缺点。我们旨在根据世界卫生组织（WHO）定义的“HH 五个时刻”概念，分享我们在烧伤中心中智能监测技术安装（IMTI）和其他模式对医护人员（HCWs）HH 依从性的初步影响结果。
进行了为期十一个月的准实验性纵向试验。研究的三个阶段中的第一阶段评估了通过 DO 获得的基本 HH 依从性。第二阶段评估了 IMTI 记录的系统定义的 HH 表现。最后，在第三阶段确定了 IMTI 和其他模式的效果。
41 名 HCWs 共执行了 15202 次 HH 操作，共观察到 20095 次 HH 机会。在安装前阶段有 455 次机会，总安装后阶段有 19640 次机会。在第二阶段（71.2%）和第三阶段（80.5%），IMTI 定义的表现率普遍明显高于 DO 获得的 HH 依从性（58.5%）。护士、物理治疗/麻醉技师和家政人员的依从性显著增加，而医生在第二阶段的依从性则没有显著增加。同时，在第三阶段，所有 HCWs 的 IMTI 和 HH 依从性的其他附加模式均观察到持续增加。
IMTI 显著提高了 HH 的表现率。此外，将 IMTI 与 WHO 推荐的多模式策略的其他附加模式相结合，似乎会影响 HCWs HH 依从性不断增加的趋势的可持续性。
