Transmisssion of infection within healthcare institutions is a significant threat to patients and staff. One of the most effective means of prevention is good hand hygiene. A research team at Toronto Rehabilitation Institute, Ontario, Canada, developed a wearable hand disinfection system with monitoring capabilities to enhance hand wash frequency. We present the findingsof the first phase of a larger study addressing the hypothesis that an electronic hand hygiene system with monitoring and reminding propertieswill increase hand hygiene compliance. This first phase focused on the acceptability and usability of the wearable electronic hand wash device ina clinical environment. The feedback from healthcare staff to the first prototype has provided evidence for the research team to continue with the development of this technology.
Hand hygiene compliance improves when alcohol-based hand products (ABHP) are provided at the point-of-care (POC). However, it is not known how many facilities have the infrastructure available to provide easy access to ABHP currently.
To describe the extent to which facilities in the Champlain Infection Control Network (CICN) provide POC access to ABHP.
A survey was conducted of all healthcare facilities in the CICN in October 2007. Sites were asked to complete a one-page questionnaire regarding number and location of ABHP dispensers on one ward in their facilities. The primary outcome measures included: the proportion of facilities providing any POC access to ABHP and the proportion of ABHP dispensers that were at POC, hallways and other areas.
A total of 18 of 59 (31%) long-term care facilities (LTCF) and 14 of 18 (78%) acute-care facilities (ACF) participated in the survey. Intensive care units (ICUs) were present in seven (50%) of the ACF. POC access to ABHP was provided in 44% of LTCF, 50% of ACF and 71% of ICUs surveyed. In LTCF 20% of ABHP dispensers were at the POC compared to 23% in ACF and 42% in ICUs.
Although ABHP is available in these settings, most dispensers are not provided at the POC. Hospitals and LTCF need to increase the number of ABHP dispensers available, with a particular emphasis on placing them at the POC in accordance with provincial guidelines.
Multicenter studies assessing hand hygiene adherence and risk factors for poor performance are scarce. In an observational study involving 13 hospitals across Ontario, Canada, we found a mean adherence rate of 31.2%, and that adherence was positively associated with nurses, single rooms, contact precautions, and the availability of alcohol hand rub dispensers.
The aim was to evaluate the usability of fidelity measures in compliance evaluation of hand hygiene.
Adherence to hand hygiene guidelines is important in terms of patient safety. Compliance measures seldom describe how exactly the guidelines are followed.
A cross-sectional observation study in a university hospital setting was conducted. Direct observation by trained staff was performed using a standardised observation form supplemented by fidelity criteria. A total of 830 occasions were observed in 13 units. Descriptive statistics (frequency, mean, percentages and range) were used as well as compliance rate by using a standard web-based tool. In addition, the binomial standard normal deviate test was conducted for comparing different methods used in evaluation of hand hygiene and in comparison between professional groups.
Measuring fidelity to guidelines was revealed to be useful in uncovering gaps in hand hygiene practices. The main gap related to too short duration of hand rubbing. Thus, although compliance with hand hygiene guidelines measured using a standard web-based tool was satisfactory, the degree of how exactly the guidelines were followed seemed to be critical.
Combining the measurement of fidelity to guidelines with the compliance rate is beneficial in revealing inconsistency between optimal and actual hand hygiene behaviour.
Evaluating fidelity measures is useful in terms of revealing the gaps between optimal and actual performance in hand hygiene. Fidelity measures are suitable in different healthcare contexts and easy to measure according to the relevant indicators of fidelity, such as the length of hand rubbing. Knowing the gap facilitates improvements in clinical practice.
The primary objective was to measure the compliance with alcohol-based surgical hand rubbing (SHR) among operation room personnel. The secondary objective was to evaluate the effect of feedback sessions on compliance.
This was a prospective observational before-after intervention study. Between October 2010 and June 2012 the hygiene nurses observed SHR among operation room personnel in the hospital district of Southwest Finland. After feedback sessions a second observation round was conducted in the main operation room of Turku University Hospital. The first observation round comprised 477 observations: 259 (54%) were doctors, 190 (40%) nurses and 28 (5%) other personnel. In the second observation round a total of 210 observations were made.
During the first round in 42% of observations the 3 min SHR time recommended by WHO was used. Median times for SHR were 1 min 50 s (range 0 min to 5 min 44 s) for doctors and 3 min 25 s (range 1 min 1 s to 8 min 15 s) for nurses, respectively (p?
The author sets forth a gas chromatographic technique for the detection of monochloracetic acid (MCAA) and its sodium salts in the air, in skin washings, overalls extracts, and urine. The substances were identified as propyl ether. The analysis was performed on a chromatograph supplied with a plasma-ionizing detector on a 2 m-long glass column, with the chromatrone N-AW-DMCS. The detection capacity in the sample was 0.005 microgram/microliter, in the air for MCAA - 0.5 mg/m3, for MCAA sodium salt - 0.25 mg/m3. Standard deviation did not exceed 0.16. The technique was tested in industrial conditions.
We investigated the association between the amount of alcohol-based hand rub (hereafter, "hand rub") used and the incidence of healthcare-acquired bloodstream infection (HCR-BSI) from 2004 through early 2008. The amount of hand rub used increased significantly, and the incidence of HCR-BSI remained stable. There was no significant association between the amount of hand rub used and the incidence of HCR-BSI.
Since 2009, all hospitals in Ontario have been mandated to publicly report health care provider compliance with hand hygiene opportunities (http://www.health.gov.on.ca/patient_safety/index.html). Hand hygiene compliance (HHC) is reported for 2 of the 4 moments during the health care provider-patient encounter. This study analyzes the HHC data by using an alternative methodology for interpretation and reporting.
Annualized HHC data were available for fiscal years 2009 and 2010 for each of the 5 hospital corporations (6 sites) in the North Simcoe Muskoka Local Health Integration Network. The weighted average for HHC was used to estimate the overall observed rate for HHC for each hospital and reporting period. Using Bayes' probability theorem, this estimate was used to predict the probability that any patient would experience HHC for at least 75% of hand hygiene moments. This probability was categorized as excellent (=75%), above average (50%-74%), below average (25%-49%), or poor (