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Validation and implementation of group electronic hand hygiene monitoring across twenty-four critical care units.
Leis, Jerome A; Obaidallah, Maryam; Williams, Victoria; Muller, Matthew P; Powis, Jeff E; Johnstone, Jennie; Hota, Susy; Katz, Kevin; Payne, Michael; Castellani, Lucas; Downing, Mark; Mertz, Dominik; Ricciuto, Daniel R; Kiss, Alex; Cuthbertson, Brian H.
  • Leis JA; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Obaidallah M; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • Williams V; Sunnybrook Research Institute, Toronto, Ontario, Canada.
  • Muller MP; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Powis JE; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
  • Johnstone J; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Hota S; St Michael's Hospital, Toronto, Ontario, Canada.
  • Katz K; Michael Garron Hospital, Toronto, Ontario, Canada.
  • Payne M; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Castellani L; Sinai Health, Toronto, Ontario, Canada.
  • Downing M; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
  • Mertz D; University Health Network, Toronto, Ontario, Canada.
  • Ricciuto DR; North York General Hospital, Toronto, Ontario, Canada.
  • Kiss A; London Health Science Centre, London, Ontario, Canada.
  • Cuthbertson BH; The Sault Area Hospital, Sault Ste. Marie, Ontario, Canada.
Infect Control Hosp Epidemiol ; 43(7): 834-839, 2022 07.
Article in English | MEDLINE | ID: covidwho-2185189
ABSTRACT

OBJECTIVES:

An accurate estimate of the average number of hand hygiene opportunities per patient hour (HHO rate) is required to implement group electronic hand hygiene monitoring systems (GEHHMSs). We sought to identify predictors of HHOs to validate and implement a GEHHMS across a network of critical care units.

DESIGN:

Multicenter, observational study (10 hospitals) followed by quality improvement intervention involving 24 critical care units across 12 hospitals in Ontario, Canada.

METHODS:

Critical care patient beds were randomized to receive 1 hour of continuous direct observation to determine the HHO rate. A Poisson regression model determined unit-level predictors of HHOs. Estimates of average HHO rates across different types of critical care units were derived and used to implement and evaluate use of GEHHMS.

RESULTS:

During 2,812 hours of observation, we identified 25,417 HHOs. There was significant variability in HHO rate across critical care units. Time of day, day of the week, unit acuity, patient acuity, patient population and use of transmission-based precautions were significantly associated with HHO rate. Using unit-specific estimates of average HHO rate, aggregate HH adherence was 30.0% (1,084,329 of 3,614,908) at baseline with GEHHMS and improved to 38.5% (740,660 of 1,921,656) within 2 months of continuous feedback to units (P < .0001).

CONCLUSIONS:

Unit-specific estimates based on known predictors of HHO rate enabled broad implementation of GEHHMS. Further longitudinal quality improvement efforts using this system are required to assess the impact of GEHHMS on both HH adherence and clinical outcomes within critically ill patient populations.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Hand Hygiene Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article Affiliation country: Ice.2021.250

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cross Infection / Hand Hygiene Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2022 Document Type: Article Affiliation country: Ice.2021.250