Schmutz, Jan B; Grande, Bastian; Sax, Hugo (2023). WHO "My Five Moments for hand hygiene" in anaesthesia induction: a video-based analysis reveals novel system challenges and design opportunities. The journal of hospital infection, 135, pp. 163-170. Elsevier 10.1016/j.jhin.2023.03.002
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BACKGROUND
Anaesthesia induction is a fast-paced, complex activity that involves a high density of hand-to-surface exposures. Hand hygiene (HH) adherence has been reported to be low, which bears the potential for unnoticed pathogen transmission between consecutive patients. Therefore, we aimed to study the fit of the WHO's five moments of HH concept to the anaesthesia induction workflow.
METHODS
We analysed video recordings of 59 anaesthesia inductions according to the WHO HH observation method considering each hand-to-surface exposure of every involved anaesthesia provider. Binary logistic regression was used to determine risk factors for non-adherence, i.e., professional category, gender, task role, gloves, holding of objects, team size and HH moment. Additionally, we re-coded half of the videos for self-touching behaviour for quantitative and qualitative analysis.
RESULTS
Overall, 2240 HH opportunities were met by 105 HH actions (4.7%). The drug administrator role (OR=2.2), the senior physician status (OR=2.1), donning (OR=2.6) and doffing (OR=3.6) of gloves were associated with higher HH adherence. Notably, 47.2% of all HH opportunities were caused by self-touching behaviour. Provider clothes, face, and patient skin were the most frequently touched surfaces.
CONCLUSIONS
The high density of hand-to-surface exposures, a high cognitive load, prolonged glove use, carried mobile objects, self-touching, and personal behaviour patterns were potential causes for non-adherence. A purpose-designed HH concept based on these results, involving the introduction of designated objects and provider clothes to the patient zone, could mitigate HH adherence and microbiologic safety.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Sax, Hugo Siegfried |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1532-2939 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
13 Mar 2023 15:38 |
Last Modified: |
11 Mar 2024 00:25 |
Publisher DOI: |
10.1016/j.jhin.2023.03.002 |
PubMed ID: |
36907335 |
BORIS DOI: |
10.48350/179932 |
URI: |
https://boris.unibe.ch/id/eprint/179932 |
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