Education of hand rubbing technique to prospective medical staff, employing UV-based digital imaging technology

The aim of this study was to objectively assess the hand hygiene performance of medical students. Hand rubbing technique was evaluated by employing innovative UV-light-based imaging technology, identifying patterns and trends in missed areas after applying WHO’s six-step protocol. This specially designed hand hygiene education and assessment program targeted 1,344 medical students at two distant sites in Central Europe. Students were introduced to a short video, presenting the basics of hand hygiene, and then received further demonstration from professional trainers, focusing on the correct execution of WHO’s six-step technique. To verify the acquired skill, participants rubbed their hands with UV-marked alcohol-based solution. Digital images of the hands were recorded under UV light, followed by computer evaluation and assessment. Immediate objective visual feedback was given to the participants showing missed areas on their hands. The statistical analysis of missed spots was based on retrospective expert-driven manual evaluation. Significant difference in rubbing quality was found between female and male participants [35.3% (CI 95%: 33–38%) versus 29.0% (CI 95%: 27–31%), p < 0.001], dominant and non-dominant hands [43.4% (CI 95%: 39–48%) versus 34.9% (CI 95%: 32–38%), p = 0.002], and various zones of the hands’ dorsal side. Based on the participants’ feedback and the evaluation of the infection control specialists, it can be stated that the identification of typically missed patterns and the instant visual feedback have a vital role in improving the hand hygiene technique of prospective medical staff

Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

The ability of healthcare workers to learn proper hand hygiene has been an understudied area of research. Generally, hand hygiene skills are regarded as a key contributor to reduce critical infections and healthcare-associated infections. In a clinical setup, at a Neonatal Intensive Care Unit (NICU), the outcome of a multi-modal training initiative was recorded, where objective feedback was provided to the staff. It was hypothesized that staff at the NICU are more sensitive towards applying increased patient safety measures. Outcomes were recorded as the ability to cover all hand surfaces with Alcohol-Based Handrub (ABHR), modelled as a time-series of measurements. The learning ability to rub in with 1.5 mL and with 3 mL was also assessed. As a secondary outcome, handrub consumption and infection numbers were recorded. It has been observed that some staff members were able to quickly learn the proper hand hygiene, even with the limited 1.5 mL, while others were not capable of acquiring the technique even with 3 mL. When analyzing the 1.5 mL group, it was deemed an insufficient ABHR amount, while with 3 mL, the critical necessity of skill training to achieve complete coverage was documented. Identifying these individuals helps the infection control staff to better focus their training efforts. The training led to a 157% increase in handrub consumption. The setting of the study did not allow to show a measurable reduction in the number of hospital infections. It has been concluded that the training method chosen by the staff greatly affects the quality of the outcomes

Quantitative impact of direct, personal feedback on hand hygiene technique

This study investigated the effectiveness of targeting hand hygiene technique using a new training device that provides objective, personal and quantitative feedback. One hundred and thirty-six healthcare workers in three Hungarian hospitals participated in a repetitive hand hygiene technique assessment study. Ultraviolet (UV)-labelled hand rub was used at each event, and digital images of the hands were subsequently taken under UV light. Immediate objective visual feedback was given to participants, showing missed areas on their hands. The rate of inadequate hand rubbing reduced from 50% to 15% (P < 0.001). However, maintenance of this reduced rate is likely to require continuous use of the electronic equipment

A kézhigiénés technika vizsgálata elektronikus ellenőrző berendezés segítségével 26 magyarországi betegellátó intézményben

Absztrakt: Bevezetés: A helyes kézhigiéné jelentőségét nem lehet vitatni. Semmelweis óta tudjuk, hogy a kézhigiéné a kórházi fertőzések megelőzésének egyik leghatékonyabb módja, amelynek fejlesztésére az oktatás, az ellenőrzés és a visszacsatolás módszere javasolt. Célkitűzés: A modern oktatási eszközök, digitális demonstráló és ellenőrző eszközök hatékonyságának felmérése a széles körű alkalmazásuk során. Módszer: Az általunk szervezett kézhigiénés továbbképzéseken 1269 egészségügyi szakdolgozó vett részt, amelynek keretében a résztvevők kézhigiénés technikáját is vizsgáltuk, felmérve a kézhigiéné során leggyakrabban kimaradó területeket. A kézhigiénés technikát digitális berendezés segítségével vizsgáltuk. Eredmények: A felmérésben részt vevők 33%-a nem megfelelően fertőtlenítette a kezét. A leggyakrabban kihagyott területek az ujjvégek (bal kézen 33%, jobb kézen 37%) és a hüvelykujjak (bal kézen 42%, jobb kézen 32%) voltak. Következtetés: A visszajelzésnek alapvető szerepe van a helyes kézhigiénés technika oktatásában és fejlesztésében, az elektronikus eszközök segítségével ez gyorsan és egyszerűen kivitelezhető, ezáltal pedig a képzés hatékonysága növelhető. Orv Hetil. 2017; 158(29): 1143–1148. | Abstract: Introduction: Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Aim: Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. Method: 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants’ hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. Results: 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). Conclusion: The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143–1148

A large-scale assessment of hand hygiene quality and the effectiveness of the “WHO 6-steps”

BACKGROUND: Hand hygiene compliance is generally assessed by observation of adherence to the “WHO five moments” using numbers of opportunities as the denominator. The quality of the activity is usually not monitored since there is no established methodology for the routine assessment of hand hygiene technique. The aim of this study was to objectively assess hand rub coverage of staff using a novel imaging technology and to look for patterns and trends in missed areas after the use of WHO’s 6 Step technique. METHODS: A hand hygiene education and assessment program targeted 5200 clinical staff over 7 days at the National University Hospital, Singapore. Participants in small groups were guided by professional trainers through 5 educational stations, which included technique-training and UV light assessment supported by digital photography of hands. Objective criteria for satisfactory hand hygiene quality were defined a priori. The database of images created during the assessment program was analyzed subsequently. Patterns of poor hand hygiene quality were identified and linked to staff demographic. RESULTS: Despite the assessment taking place immediately after the training, only 72% of staff achieved satisfactory coverage. Failure to adequately clean the dorsal and palmar aspects of the hand occurred in 24% and 18% of the instances, respectively. Fingertips were missed by 3.5% of subjects. The analysis based on 4642 records showed that nurses performed best (77% pass), and women performed better than men (75% vs. 62%, p<0.001). Further risk indicators have been identified regarding age and occupation. CONCLUSION: Ongoing education and training has a vital role in improving hand hygiene compliance and technique of clinical staff. Identification of typical sites of failure can help to develop improved training

A kézhigiénés technika vizsgálata elektronikus ellenőrző berendezés segítségével 26 magyarországi betegellátó intézményben | Hand hygiene technique assessment using electronic equipment in 26 Hungarian healthcare institutes

Absztrakt: Bevezetés: A helyes kézhigiéné jelentőségét nem lehet vitatni. Semmelweis óta tudjuk, hogy a kézhigiéné a kórházi fertőzések megelőzésének egyik leghatékonyabb módja, amelynek fejlesztésére az oktatás, az ellenőrzés és a visszacsatolás módszere javasolt. Célkitűzés: A modern oktatási eszközök, digitális demonstráló és ellenőrző eszközök hatékonyságának felmérése a széles körű alkalmazásuk során. Módszer: Az általunk szervezett kézhigiénés továbbképzéseken 1269 egészségügyi szakdolgozó vett részt, amelynek keretében a résztvevők kézhigiénés technikáját is vizsgáltuk, felmérve a kézhigiéné során leggyakrabban kimaradó területeket. A kézhigiénés technikát digitális berendezés segítségével vizsgáltuk. Eredmények: A felmérésben részt vevők 33%-a nem megfelelően fertőtlenítette a kezét. A leggyakrabban kihagyott területek az ujjvégek (bal kézen 33%, jobb kézen 37%) és a hüvelykujjak (bal kézen 42%, jobb kézen 32%) voltak. Következtetés: A visszajelzésnek alapvető szerepe van a helyes kézhigiénés technika oktatásában és fejlesztésében, az elektronikus eszközök segítségével ez gyorsan és egyszerűen kivitelezhető, ezáltal pedig a képzés hatékonysága növelhető. Orv Hetil. 2017; 158(29): 1143–1148. | Abstract: Introduction: Hand hygiene is probably the most effective tool of nosocomial infection prevention, however, proper feedback and control is needed to develop the individual hand hygiene practice. Aim: Assessing the efficiency of modern education tools, and digital demonstration and verification equipment during their wide-range deployment. Method: 1269 healthcare workers took part in a training organized by our team. The training included the assessment of the participants’ hand hygiene technique to identify the most often missed areas. The hand hygiene technique was examined by a digital device. Results: 33% of the participants disinfected their hands incorrectly. The most often missed sites are the fingertips (33% on the left hand, 37% on the right hand) and the thumbs (42% on the left hand, 32% on the right hand). Conclusion: The feedback has a fundamental role in the development of the hand hygiene technique. With the usage of electronic devices feedback can be provided efficiently and simply. Orv Hetil. 2017; 158(29): 1143–1148

Kortárs egészségfejlesztési programok közvetlen hatása alsó tagozatos gyermekek kézhigiénés tudására és megfelelő kézmosási technikájára

INTRODUCTION AND AIM: In the case of primary school children in Budapest (n = 165), data on their social status and their previous knowledge on hand hygiene were elicited with the help of pre-knowledge questionnaires issued by students of higher education. The aim of the research was introducing a novel pedagogical procedure - application and optimization of peer education in the development of proper hand hygiene among primary school students. METHOD: The knowledge-based survey was conducted after four (n = 85) and eight hours of teaching (n = 36). In addition, the effectiveness of hand washing was tested immediately before (n = 166) and after the four (n = 74) and eight hours of teaching (n = 35) with Semmelweis Scanner after rubbing the hand with fluorescent cream. RESULTS: Prior knowledge of hand hygiene significantly increased after the four-hour and eight-hour trainings. In the case of smaller children, the effect of the eight-hour training was more pronounced. Similar results were obtained with regards to the changes in the number of areas missed while rubbing the surface of the hand as a result of the teaching. CONCLUSION: Sociological surveys on hand hygiene knowledge and direct physical measurements indicate that training with appropriate pedagogical procedures is effective and contributes to the environmentally conscious hygiene culture of children aged 6 to 10. Orv Hetil. 2018; 159(12): 485-490