Katherine J McKay1, Patricia E Ferguson2, Ramon Z Shaban3. 1. Infection Prevention and Control, Eastern Health, Box Hill, Victoria, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia. Electronic address: Kmck4637@uni.sydney.edu.au. 2. Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Centre for Infectious Diseases and Microbiology, Westmead Hospital, Western Sydney Local Health District, Westmead, NSW, Australia. 3. Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia; Marie Bashir Institute for Infectious Diseases and Biosecurity, Faculty of Medicine and Health, University of Sydney, NSW, Australia; Department of Infection Prevention and Control, Division of Infectious Diseases and Sexual Health, Westmead Hospital and Western Sydney Local Health District, Westmead, NSW, Australia; New South Wales Biocontainment Centre, Western Sydney Local Health District and New South Wales Health, NSW, Australia.
Abstract
BACKGROUND: Direct observation is the gold standard method for measuring hand hygiene compliance but its utility is increasingly being questioned. Various alternative electronic methods have been proposed, yet there is a paucity of research examining the use of these according to the World Health Organization's (WHO) '5 Moments for Hand Hygiene'. As a part of the process of developing a video-based monitoring system (VMS) capable of measuring hand hygiene compliance against the 5 moments criteria this paper reports methodological and technical issues that might arise from the use of a VMS for auditing in clinical practice. METHODS: In-depth semi-structured interviews were conducted with 27 Australian content experts in hand hygiene auditing and infection prevention to explore their responses to proposed VMS auditing approaches. Transcripts were analysed using thematic and content analysis. RESULTS: Technical and methodological considerations for the use of VMS were interrelated and included concerns surrounding privacy, footage security, fears of surveillance and the potential for medico-legal consequences. Additionally, possible detrimental impacts on healthcare worker (HCW) -patient relationships, issues of cost versus benefits, HCW and patient safety and changes to feedback were also identified. CONCLUSIONS: The primary methodological and technical issues to overcome in order to implement VMS for hand hygiene auditing in clinical practice, centred upon issues of acceptability to patients and health professionals, privacy, consent and liability. CHECKLIST: COREQ.
BACKGROUND: Direct observation is the gold standard method for measuring hand hygiene compliance but its utility is increasingly being questioned. Various alternative electronic methods have been proposed, yet there is a paucity of research examining the use of these according to the World Health Organization's (WHO) '5 Moments for Hand Hygiene'. As a part of the process of developing a video-based monitoring system (VMS) capable of measuring hand hygiene compliance against the 5 moments criteria this paper reports methodological and technical issues that might arise from the use of a VMS for auditing in clinical practice. METHODS: In-depth semi-structured interviews were conducted with 27 Australian content experts in hand hygiene auditing and infection prevention to explore their responses to proposed VMS auditing approaches. Transcripts were analysed using thematic and content analysis. RESULTS: Technical and methodological considerations for the use of VMS were interrelated and included concerns surrounding privacy, footage security, fears of surveillance and the potential for medico-legal consequences. Additionally, possible detrimental impacts on healthcare worker (HCW) -patient relationships, issues of cost versus benefits, HCW and patient safety and changes to feedback were also identified. CONCLUSIONS: The primary methodological and technical issues to overcome in order to implement VMS for hand hygiene auditing in clinical practice, centred upon issues of acceptability to patients and health professionals, privacy, consent and liability. CHECKLIST: COREQ.
Authors: Kate Curtis; Peter Jansen; Margot Mains; Anna O'Hare; Bradley Scotcher; David Alcorn; Shizar Nahidi; Joanna Harris; Daniel Brouillard; Sarah Morton; Ramon Z Shaban Journal: Australas Emerg Care Date: 2022-01-31