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Effect of Video Camera Monitoring Feedback on Hand Hygiene Compliance in Neonatal Intensive Care Unit, an Interventional Study

Published:January 02, 2023DOI:https://doi.org/10.1016/j.ajic.2022.12.011

      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 and insignificant improvement.
      • 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. This shows the importance of continuous and frequent feedback and educations to sustain a high hand hygiene and glove use compliance.

      Abstract

      Objective

      The purpose of this study is to determine whether use of the video camera surveillance system for hand hygiene (HH) monitoring, video-based education and feedback can improve the HH compliance in a neonatal intensive care unit (NICU).

      Methods

      This is an interventional before-after trial conducted in a level-III NICU between July 2019-June 2020. The HH compliance was measured using the randomly selected video-camera footages 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 the HH compliance change. The compliance rates were tested as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study periods.

      Results

      We identified a total of 8335 HH indications. There was an increase in the total compliance rate of 9.0% (95% CI(-2%-20%)) at the time of intervention with increase in rate after intervention of 0.26% (95% CI(-0.31%-0.84%)) per day. The hand hygiene compliance before-patient contact significantly increase 19.8% (95% CI(4.8%-34.8%). Incorrect gloves use improved insignificantly with the intervention -3.4% (95% CI(-13.4%-6.7%)).

      Conclusion

      In this study HH monitoring using video-camera footage combined with an intervention includes feedback, and education improved 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

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