Subject(s)
Cross Infection/prevention & control , Guideline Adherence , Hand Hygiene , Infection Control/methods , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/prevention & control , Cross Infection/microbiology , Health Facilities , Humans , Staphylococcal Infections/microbiologyABSTRACT
Electronic monitoring of hand hygiene compliance using the World Health Organization's My 5 Moments for Hand Hygiene is a new innovation that has not yet been shown to reduce hospital infections. We analyzed existing data from 23 inpatient units over a 33-month period and found a significant correlation between unit-specific improvements in electronic monitoring compliance and reductions in methicillin-resistant Staphylococcus aureus infection rates (r = -0.37, P < .001).
Subject(s)
Behavior Observation Techniques/methods , Cross Infection/prevention & control , Disease Transmission, Infectious/prevention & control , Electronics, Medical , Hand Hygiene/methods , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/prevention & control , Cross Infection/microbiology , Health Facilities , Health Services Research , Humans , Staphylococcal Infections/microbiologyABSTRACT
BACKGROUND: Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital. METHODS: An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used. RESULTS: The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS. DISCUSSION: In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH. CONCLUSIONS: The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH.
Subject(s)
Alcohols/administration & dosage , Disinfectants/administration & dosage , Disinfection/statistics & numerical data , Guideline Adherence , Hand Sanitizers , Visitors to Patients , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hospitals , Humans , Male , Middle Aged , Young AdultABSTRACT
BACKGROUND: We previously published a formula to estimate the number of hand hygiene opportunities (HHOs) per patient-day using the World Health Organization's "Five Moments for Hand Hygiene" methodology (HOW2 Benchmark Study). HHOs can be used as a denominator for calculating hand hygiene compliance rates when product utilization data are available. This study validates the previously derived HHO estimate using 24-hour video surveillance of health care worker hand hygiene activity. METHODS: The validation study utilized 24-hour video surveillance recordings of 26 patients' hospital stays to measure the actual number of HHOs per patient-day on a medicine ward in a large teaching hospital. Statistical methods were used to compare these results to those obtained by episodic observation of patient activity in the original derivation study. RESULTS: Total hours of data collection were 81.3 and 1,510.8, resulting in 1,740 and 4,522 HHOs in the derivation and validation studies, respectively. Comparisons of the mean and median HHOs per 24-hour period did not differ significantly. HHOs were 71.6 (95% confidence interval: 64.9-78.3) and 73.9 (95% confidence interval: 69.1-84.1), respectively. CONCLUSION: This study validates the HOW2 Benchmark Study and confirms that expected numbers of HHOs can be estimated from the unit's patient census and patient-to-nurse ratio. These data can be used as denominators in calculations of hand hygiene compliance rates from electronic monitoring using the "Five Moments for Hand Hygiene" methodology.
Subject(s)
Benchmarking , Hand Hygiene/statistics & numerical data , Hand Hygiene/standards , Age Factors , Aged , Bed Occupancy/statistics & numerical data , Female , Guideline Adherence , Hospitals, Teaching , Humans , Male , Middle Aged , Nursing/organization & administration , Nursing/statistics & numerical data , Patients' Rooms , Practice Guidelines as Topic , Time Factors , Video RecordingABSTRACT
BACKGROUND: Measurement and monitoring of health care workers' hand hygiene compliance (i.e., actions/opportunities) is a key component of strategies to eliminate hospital-acquired infections. Little data exist on the expected number of hand hygiene opportunities (HHOs) in various hospital settings, however. The purpose of this study was to estimate HHOs in 2 types of hospitals--large teaching and small community--and 3 different clinical areas-medical-surgical intensive care units, general medical wards, and emergency departments. METHODS: HHO data were collected through direct observations using the World Health Organization's monitoring methodology. Estimates of HHOs were developed for 12-hour AM/PM shifts and 24-hour time frames. RESULTS: During 436.7 hours of observation, 6,640 HHOs were identified. Estimates of HHOs ranged from 30 to 179 per patient-day on inpatient wards and from 1.84 to 5.03 per bed-hour in emergency departments. Significant differences in HHOs were found between the 2 hospital types and among the 3 clinical areas. CONCLUSION: This study is the first to use the World Health Organization's data collection methodology to estimate HHOs in general medical wards and emergency departments. These data can be used as denominator estimates to calculate hand hygiene compliance rates when product utilization data are available.
Subject(s)
Cross Infection/prevention & control , Hand Disinfection/methods , Health Personnel , Health Services Research/methods , Infection Control/methods , Hospitals , HumansABSTRACT
Due to the events of September 11, 2001 and the bioterrorism-related anthrax episodes, the United States has escalated efforts to better prepare the nation for terrorist attacks. Early recognition and management of a biological attack are largely dependent on the clinical expertise of frontline health care personnel. Nurses are recognized as an integral part of this team. Schools of nursing should integrate bioterrorism education into their curricula to address this growing frontier of health care management. This article outlines the necessary components of bioterrorism education for nurses, reviews examples of available resources to facilitate its inclusion, and suggests ways to integrate this material into nursing curricula.
Subject(s)
Bioterrorism/prevention & control , Curriculum/standards , Disaster Planning/organization & administration , Education, Nursing/organization & administration , Nurse's Role , Anthrax/prevention & control , Clinical Competence , Community Health Planning/organization & administration , Humans , Models, Nursing , Needs Assessment , United StatesABSTRACT
South Carolina's Greenville Hospital System (GHS) minimizes caregivers' exposure to blood and body fluid through a risk-reduction program that hinges on feedback from data analysis and frontline staff.