Abstract
IntroductionHand hygiene is a key component of infection control in healthcare. WHO recommends that healthcare workers perform six specific poses during each hand hygiene action. SureWash (Glanta Ltd, Dublin, Ireland) is a novel device that uses video-measurement technology and immediate feedback to teach this technique. We assessed the impact of self-directed SureWash use on healthcare worker hand hygiene technique and evaluated the device's diagnostic capacity.MethodsA controlled before-after study: subjects in Group A were exposed to the SureWash for four weeks followed by Group B for 12 weeks. Each subject's hand hygiene technique was assessed by blinded observers at baseline (T0) and following intervention periods (T1 and T2). Primary outcome was performance of a complete hand hygiene action, requiring all six poses during an action lasting ≥20 seconds. The number of poses per hand hygiene action (maximum 6) was assessed in a post-hoc analysis. SureWash's diagnostic capacity compared to human observers was assessed using ROC curve analysis.ResultsThirty-four and 29 healthcare workers were recruited to groups A and B, respectively. No participants performed a complete action at baseline. At T1, one Group A participant and no Group B participants performed a complete action. At baseline, the median number of poses performed per action was 2.0 and 1.0 in Groups A and B, respectively (p = 0.12). At T1, the number of poses per action was greater in Group A (post-intervention) than Group B (control): median 3.8 and 2.0, respectively (p<0.001). In Group A, the number of poses performed twelve weeks post-intervention (median 3.0) remained higher than baseline (p<0.001). The area under the ROC curves for the 6 poses ranged from 0.59 to 0.88.DiscussionWhile no impact on complete actions was demonstrated, SureWash significantly increased the number of poses per hand hygiene action and demonstrated good diagnostic capacity.
Highlights
IntroductionWHO recommends that healthcare workers perform six specific poses during each hand hygiene action
Hand hygiene is a key component of infection control in healthcare
While no impact on complete actions was demonstrated, SureWash significantly increased the number of poses per hand hygiene action and demonstrated good diagnostic capacity
Summary
WHO recommends that healthcare workers perform six specific poses during each hand hygiene action. We assessed the impact of selfdirected SureWash use on healthcare worker hand hygiene technique and evaluated the device’s diagnostic capacity. The contemporary approach to promotion of hand hygiene amongst healthcare workers involves a multimodal strategy incorporating the use of alcohol-based handrub at the point of care [1,2]. WHO recommendations exist for how to perform hand hygiene, but these are rarely monitored or included in performance feedback programs. This technique is based on European standards (EN 1500) and involves six distinct steps, or poses [1]. Correct performance of this technique results in increased product coverage and greater reductions of bacterial colony forming units when compared with incomplete actions [6,7]
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