Highlights
- •Overall hand hygiene compliance before the intervention was low (44.1%) which was in line with other studies performed in intensive care units.
- •After our video camera hand hygiene surveillance, scenario based interactive education and feedback intervention, the overall hand hygiene and glove showed a non-significant improvement.
- •Only the before patient contact hand hygiene compliance rate increased significantly.
- •The improvements in hand hygiene behavior were not sustained in the long term (6 months after the intervention) follow period., illustrating the probable importance of continuous and frequent feedback and educations to sustain hand hygiene compliance.
Abstract
Background
The purpose of this study was to determine whether use of a video camera surveillance
system for hand hygiene (HH) monitoring, video-based education, and feedback could
improve the HH compliance in a neonatal intensive care unit (NICU).
Methods and materials
This was an interventional before-after trial conducted in a level-III NICU between
July 2019 and June 2020. HH compliance was measured using randomly selected video-camera
footage in the baseline, intervention, and maintenance periods. After the baseline,
an intervention consisting of feedback and education with video scenarios was implemented.
The primary outcome was change in HH compliance. The compliance rates were analyzed
as an interrupted time series (ITS) with a segmented regression model adjusted for
autocorrelation for each study period.
Results
We identified a total of 8335 HH indications. There were non significant increases
in the total compliance rate (9.0%, 95% CI -2% to 20%) at the time of intervention
and in the compliance rate after intervention (0.26%, 95% CI -0.31% to 0.84%) per
day. The hand hygiene compliance before patient contact significantly increased (19.8%,
95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention
(-3.4%, 95% CI -13.4% to 6.7%).
Conclusion
In this study of HH monitoring using video-camera footage combined with an intervention
including feedback and education, there were inconsistent improvements in HH compliance.
However, these improvements were not sustained in the long term. Frequent feedback
and education may be required to sustain high compliance.
Graphical abstract
Graphical Abstract
Key Words
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Article info
Publication history
Published online: January 02, 2023
Publication stage
In Press Journal Pre-ProofFootnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
