Game-based training to improve the compliance of hospital pharmacy operators with handwashing guidelines

Abstract

IntroductionGood hand hygiene techniques (HHTs), like those of the World Health Organization (WHO), prevent microbial contamination of aseptic preparations. Our objective was to assess the efficacy of a game-based training (GBT) tool (the Handtastic Box®) to improve compliance in hospital pharmacy operators (HPOs) practice. MethodsA camera recorded HPOs’ handwashing 1 month before the training, between training and month 1 (M1), and between month 1 and month 3 (M2&3). Movements were scored as fully executed, partially executed, or not executed. We compared each HPO’s compliance rates with HHTs between observation periods. During 1-hour training sessions, pairs of HPO trainees watched videos of someone handwashing and had to note down which of the guidelines’ 5 steps was missing. They examined wooden hands having areas stained with fluorescein under ultraviolet light to find the hand showing the matching contamination. ResultsThe mean compliance score for 9 HPOs rose from 44.6% (before, n=32 videos) to 86.7% (M1, n=40) to 82.5% (M2&3, n=45). Compliance with every step improved from before training to M1 and generally stabilised in M2&3, except for the fingertip washing step, which dropped significantly at M2&3. DiscussionThis study was the first to assess a GBT tool’s efficacy in improving compliance with the WHO’s HHTs in HPOs’ practice. It significantly improved handwashing scores and maintained them at the same level until M3. The separate results for each step highlighted the necessity of training every movement. ConclusionThis GBT tool successfully improved compliance with the WHO’s HHT out to 3 months. This training could be used for other healthcare professionals.