Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU
Abstract
:1. Introduction
Problem Statement and Hypothesis
- (1)
- The main institutional level risk is that imperfect HH is dangerous for the patients and the staff; and with ABHR, the correct technique needs to be learned: the goal is to achieve perfect HH, and thus reduce the risk of infection;
- (2)
- Hospitals invest a lot of energy in staff training, but we do not know how effective it is (typically, their shortcomings can be observed easily): the goal is to know and apply effective training methods;
- (3)
- There is a large deviation in ABHR consumption: while 1 mL is a straight precursor for inadequate hygiene, 8 mL is waste—therefore the hospital’s goal is to reach an optimal level and establish the range for the staff that guarantees complete HH.
2. Materials and Methods
2.1. Measurements
2.2. Statistical Analysis
2.3. Learning Modelling
3. Results
4. Discussion
- -
- Low ABHR volume correlates with transmission risk, therefore monitoring ABHR application volume per HH event can be a proxy for quality outcome;
- -
- With 1.5 mL ABHR only, the learning curve is slower, which imposes a patient risk at a NICUr
- -
- The faster competence acquisition including 3 mL ABHR mean a saving on training time;
- -
- Complete hand coverage is far from trivial even with 3 mL ABRH, therefore, regular skill training is required;
- -
- It was observed that the quality of HH strongly correlated with the size of the hands, therefore larger hands are supposed to receive larger amounts of ABHR.
5. Limitations and Future Work
- (a)
- It reduces the number of events—this means an increase in quality of life and a decrease in costs;
- (b)
- Speeds up learning—this saves on personnel costs (but depends on staff turnover, etc.);
- (c)
- Can increase disinfectant loss if too low—it is not known if it reduces wastage (it depends on the pattern of disinfectant loss).
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Classification | Physicians | Other HCWs | |
---|---|---|---|
Gender | Male | 3 | 0 |
Female | 7 | 29 | |
Dominant hand | Left | 1 | 3 |
Right | 9 | 26 | |
Age | <25 | 0 | 2 |
26–35 | 4 | 0 | |
36–45 | 4 | 12 | |
46–55 | 2 | 14 | |
>56 | 0 | 1 | |
Total participants | 10 | 29 |
Year | ABHR Con-Sumption (L) | Patient Days (PD) | L/1000 PD | Patients Tracked w/Microbiology Surveillance | Patients Affected by HAI | Number of Reported HAI | BSI within the HAI |
---|---|---|---|---|---|---|---|
2015 | 591 | 3853.5 | 153.4 | 69 | 9 | 12 | 8 |
2016 | 530 | 2203.5 | 240.5 | 43 | 11 | 19 | 13 |
2017 | 620 | 4764 | 130.1 | 32 | 15 | 12 | 5 |
2018 | 698 | 6524.5 | 106.1 | 59 | 5 | 5 | 1 |
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Németh, I.A.K.; Nádor, C.; Szilágyi, L.; Lehotsky, Á.; Haidegger, T. Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU. J. Clin. Med. 2022, 11, 4276. https://doi.org/10.3390/jcm11154276
Németh IAK, Nádor C, Szilágyi L, Lehotsky Á, Haidegger T. Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU. Journal of Clinical Medicine. 2022; 11(15):4276. https://doi.org/10.3390/jcm11154276
Chicago/Turabian StyleNémeth, Irén A. Kopcsóné, Csaba Nádor, László Szilágyi, Ákos Lehotsky, and Tamás Haidegger. 2022. "Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU" Journal of Clinical Medicine 11, no. 15: 4276. https://doi.org/10.3390/jcm11154276
APA StyleNémeth, I. A. K., Nádor, C., Szilágyi, L., Lehotsky, Á., & Haidegger, T. (2022). Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU. Journal of Clinical Medicine, 11(15), 4276. https://doi.org/10.3390/jcm11154276