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Dear All,
Further to my posting yesterday the results from the following research
undertaken in NSW is also noteworthy.Yen Lee Angela Kwok et al. Automated hand hygiene auditing with and without
an intervention. American Journal of Infection Control 44 (2016) 1475-80. “HHA rates (Hand Hygiene Australia human audits) for June 2014
were 85% and 87% on the medical and surgical wards, respectively. These
rates were 55 percentage points (PPs) and 38 PPs higher than covert
automation rates for June 2014 on the medical and surgical ward at 30% and
49%, respectively. During the intervention phase, average compliance did not
change on the medical ward from their covert rate, whereas the surgical ward
improved compared with the covert phase by 11 PPs to 60%. On average,
compliance during the intervention without being refreshed did not change on
the medical ward, whereas the average rate on the surgical ward declined by
9 PPs”.Regards
Glenys
Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
observational audits and unrealistic performance indicators (targets) for
hand hygiene compliance?Dear All,
It is now time to pull back on time consuming hand hygiene observational
audits and unrealistic performance indicators (targets) for hand hygiene
compliance?Recent publications suggest it is now time to review and rethink such
programs in developing and developed countries to ensure an evidence based
approach to hand hygiene and cost effective use of infection prevention and
control resources.HH compliance papers
Kingston L et al. Hand hygiene-related clinical trials reported since 2010:
a systematic review. Journal of Hospital Infection 92 (2016) 309-320. “We concluded that adopting a multimodal approach to hand hygiene
improvement intervention strategies, whether guided by the WHO framework or
by another tested multimodal framework, results in moderate improvements in
hand hygiene compliance”.Hand hygiene compliance: are we kidding ourselves? Editorial, Journal of
Hospital Infection 92 (2016) 307-308. “It is clear that monitoring hand hygiene compliance using direct
observation is flawed and that electronic devices/methods in combination
with smaller observational audits using appropriately trained staff would
enable a better assessment….. Hence, in an era of multi-resistant
Gram-negative bacteria, it is now time to take stock and consider that we
have spent a number of years performing research on hand hygiene with little
evidence that any particular strategy works. Perhaps future research should
be focused not on campaigns to improve hand hygiene at all costs, but on
understanding when hand hygiene is most beneficial, setting reasonable,
achievable targets, and then monitoring using validated, reproducible
methods”.Scheithauer S et al. Workload even affects hand hygiene in a highly trained
and well-staffed setting: a prospective 365/7/24 observational study.
Journal of Hospital Infection 97 (2017) 11-16. “Calculated compliance was inversely associated with nurses’
workload. Hand-rub activities (HRA)/patient-day (PD), observer-determined
compliance and amount of disinfectant dispensed were used as surrogates for
compliance, but did not correlate with actual compliance and thus should be
used with caution”.Regards
Glenys
Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
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