Abstract
BackgroundHospital-acquired infections are still amongst the major problems health systems are facing. Their occurrence can lead to higher morbidity and mortality rates, increased length of hospital stay, and higher costs for both hospital and patients. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers’ compliance with it is often far from ideal. To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time feedback accurately in a fun and engaging way.MethodsA Design Science Research Methodology (DSRM) was used to conduct this work. DSRM is useful to study the link between research and professional practices by designing, implementing and evaluating artifacts that address a specific need. It follows a development cycle (or iteration) composed by six activities. Two work iterations were performed applying gamification components, each using a different indoor location technology. Preliminary experiments, simulations and field studies were performed in an Intensive Care Unit (ICU) of a Portuguese tertiary hospital. Nurses working on this ICU were in a focus group during the research, participating in several sessions across the implementation process.ResultsNurses enjoyed the concept and considered that it allows for a unique opportunity to receive feedback regarding their performance. Tests performed on the indoor location technology applied in the first iteration regarding distances estimation presented an unacceptable lack of accuracy. Using a proximity-based technique, it was possible to identify the sequence of positions, but beacons presented an unstable behaviour. In the second work iteration, a different indoor location technology was explored but it did not work properly, so there was no chance of testing the solution as a whole (gamification application included).ConclusionsCombining automated monitoring systems with gamification seems to be an innovative and promising approach, based on the already achieved results. Involving nurses in the project since the beginning allowed to align the solution with their needs. Despite strong evolution through recent years, indoor location technologies are still not ready to be applied in the healthcare field with nursing wards.
Highlights
Hospital-acquired infections are still amongst the major problems health systems are facing
This choice is justified by the fact that Intensive Care Unit (ICU) wards are very demanding in terms of hygiene, and a good place to perform a proof of concept as the one proposed in this research study
This ICU is composed by three rooms; each room is equipped with one sink, one alcohol-based hand rub (ABHR) dispenser near the entrance and one ABHR dispenser at the bottom of each bed
Summary
Hospital-acquired infections are still amongst the major problems health systems are facing. Hospital-acquired infections (HAIs) are infections acquired by patients in a hospital facility while receiving treatment for medical or surgical conditions, and in whom the infection was not present nor in incubation at the time of admission [1, 2] Partially preventable, these infections cause more deaths than AIDS, breast cancer and car accidents altogether [3]. These infections cause more deaths than AIDS, breast cancer and car accidents altogether [3] It is still one of the biggest preventable problems healthcare is facing, leading directly to around 37 000 deaths, 16 million extra-days of hospital stay and €7 billion financial losses of direct costs, only in the Europe [1].
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