Highlights
- •Direct observation is increasingly considered a flawed data collection method for hand hygiene auditing
- •Electronic alternatives, while recommended, are largely incompatible with the WHO “5 Moments”
- •Video-based monitoring systems (VMS) offer a possible solution but present methodological and technical challenges
- •Success of future VMS technology for hand hygiene auditing will particularly need to consider patient and health professional acceptability.
Background
Direct observation is the gold standard method for measuring hand hygiene compliance
but its utility is increasingly being questioned. Various alternative electronic methods
have been proposed, yet there is a paucity of research examining the use of these
according to the World Health Organization's (WHO) ‘5 Moments for Hand Hygiene’. As
a part of the process of developing a video-based monitoring system (VMS) capable
of measuring hand hygiene compliance against the 5 moments criteria this paper reports
methodological and technical issues that might arise from the use of a VMS for auditing
in clinical practice.
Methods
In-depth semi-structured interviews were conducted with 27 Australian content experts
in hand hygiene auditing and infection prevention to explore their responses to proposed
VMS auditing approaches. Transcripts were analyzed using thematic and content analysis.
Results
Technical and methodological considerations for the use of VMS were interrelated and
included concerns surrounding privacy, footage security, fears of surveillance and
the potential for medico-legal consequences. Additionally, possible detrimental impacts
on healthcare worker (HCW) -patient relationships, issues of cost versus benefits,
HCW and patient safety and changes to feedback were also identified.
Conclusions
The primary methodological and technical issues to overcome in order to implement
VMS for hand hygiene auditing in clinical practice, centered upon issues of acceptability
to patients and health professionals, privacy, consent and liability.
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Article info
Publication history
Published online: April 30, 2021
Footnotes
Conflict of Interest: None to report.
Funding/support: This study was supported by a University of Sydney PhD candidate stipend, and research grant funding from the Marie Bashier Institute for Infectious Disease and Biosecurity at the University of Sydney.
Authors contrivutions: RZS established the study concept and the warrant for the manuscript. KMc and RZS drafted the paper, and all authors had critical input.
Identification
Copyright
© 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
