Abstract
Background: Electronic hand hygiene surveillance systems are developing and considered to be more reliable than direct observation for hand hygiene monitoring. However, none have the capability to assess compliance in complex nursing care.Materials and Methods: We combined two different technologies, a hand hygiene monitoring system (radiofrequency identification, RFID) and a nursing care recorder at the bedside, and we merge their data to assess hand hygiene performance during nursing. Nursing tasks were classified as standard task procedures or aseptic task procedures corresponding to moment 2 among the five moments for hand hygiene recommended by the WHO. All statistical analyses were performed using R, version 3.6.2. For mixed models, the package “lme4” was used.Results: From the merged database over the 2-year study period, 30,164 nursing tasks were identified for analysis, 25,633 were classified as standard task procedures, and 4,531 were classified as aseptic task procedures for nursing care. Hand disinfection with an alcohol-based solution was not detected with our system in 42.5% of all the recorded tasks, 37% of all the aseptic task procedures, and 47.1% of all the standard task procedures for nursing (p = 0.0362), indicating that WHO moment 2 was not respected in 37% of mandatory situations.Conclusion: Using a combination of different technologies, we were able to assess hand hygiene performance in the riskiest circumstances.
Highlights
It is generally believed that hand hygiene reduces the prevalence of hospital-acquired infections (HAIs), and that inadequate hand hygiene is one of the main risk factors for infection [1,2,3,4].The risk of transmission of microbes from the hands of healthcare workers (HCWs) to patients has been studied extensively in peripheral venous catheters (PVCs), which have long been associated with infection [4,5,6].Appropriate hand disinfection prior to PVC insertion significantly reduces the incidence of infection [5,6,7,8]
We have developed a tool to record the task of a nurse at the bedside of the patient that we called patient smart reader (PSR) [13]
This study aimed to evaluate the hand hygiene of nurses before an aseptic task procedure using merge data provided by our automatic hand hygiene monitoring system coupled with the PSR
Summary
It is generally believed that hand hygiene reduces the prevalence of hospital-acquired infections (HAIs), and that inadequate hand hygiene is one of the main risk factors for infection [1,2,3,4].The risk of transmission of microbes from the hands of healthcare workers (HCWs) to patients has been studied extensively in peripheral venous catheters (PVCs), which have long been associated with infection [4,5,6].Appropriate hand disinfection prior to PVC insertion significantly reduces the incidence of infection [5,6,7,8]. The risk of transmission of microbes from the hands of healthcare workers (HCWs) to patients has been studied extensively in peripheral venous catheters (PVCs), which have long been associated with infection [4,5,6]. Direct observation is the current gold standard to appreciate compliance to hand hygiene. IoT and Hand Hygiene risk for transmission has been suggested [9]. This model was used to develop “My Five Moments for Hand Hygiene” [10, 11]. While Moment 2 appears as a very important clue to cross transmission, its monitoring by direct observation is difficult as events are relatively infrequent compared with moments 1 and 5. Electronic hand hygiene surveillance systems are developing and considered to be more reliable than direct observation for hand hygiene monitoring. None have the capability to assess compliance in complex nursing care
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