4 research outputs found
Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology
This SHEA white paper identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19) with a focus on core principles of healthcare epidemiology. These gaps, revealed during the worst phases of the COVID-19 pandemic, are described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three critical healthcare epidemiology research questions with detailed description provided in supplementary materials. This research agenda calls for translational studies from laboratory-based basic science research to well-designed, large-scale studies and health outcomes research. Research gaps and challenges related to nursing homes and social disparities are included. Collaborations across various disciplines, expertise and across diverse geographic locations will be critical
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The Hawthorne effect on adherence to hand hygiene in patient care: a systematic review
Background: Numerous studies demonstrate that the Hawthorne effect (behaviour change caused by awareness of being observed) increases health workers’ hand hygiene adherence but it is not clear if they are methodologically robust, magnitude of the effect, how long it persists or whether it is the same across clinical settings.
Objective: Determine rigour of the methods used to assess the Hawthorne effect on hand hygiene, effect size estimation, variations between clinical settings and persistence.
Methods: Systematic literature review with meta-analysis.
Results: Nine studies met the criteria for the review. Methodological quality was poor. Data pooling was possible across six studies. The Hawthorne effect ranged from 4.2% to 65.3% with a median of 35.6%. It was 4.2% in one study conducted in intensive care and 16.4% in transplant units. It was most marked when data were collected across an entire hospital and in a group of general hospitals. Differences between wards in the same hospital were apparent. In the two studies where duration was estimated, the Hawthorne effect appeared transient.
Conclusions: Despite methodological shortcomings the review indicates clear evidence of a Hawthorne effect on general wards. There is some evidence that it may vary according to clinical specialty and across different wards within the same organisation. The review identifies a need for standardised methodologies to measure the Hawthorne effect in hand hygiene to overcome the dilemma of reporting the potentially inflated rates of adherence obtained through overt audit. Occasional covert audit could give a better estimation of ‘real’ hand hygiene adherence but its acceptability and feasibility to health workers need to be explored