Electronic Hand Hygiene Monitoring and ICU Infection Rates

NCT02511925 | Completed

• 1 other identifier: 2013IC004B
• Study Type: observational
• Target: 1,065
• Locations: 1 country
• Sites: 1

Brief Summary

If patients acquire a new infection whilst in hospital this can cause significant morbidity, prolonged hospitalisation and even death. Indeed, there is much public concern about infections such as MRSA. Patients who require intensive care are probably at the greatest risk. Appropriate hand hygiene by healthcare workers can reduce infection rates and is a key goal of many patient safety initiatives. Worldwide, hand hygiene compliance has been estimated at only 38.7% despite the intervention being simple and cheap. Reasons for poor compliance include lack of time, skin irritation, lack of facilities, intensity of workload and forgetfulness. Furthermore, since cross infection may not be apparent for some days, staff may not associate their (lack of) actions with having caused harm. Measuring compliance levels enables staff to understand whether they could improve. Direct observation of staff is labour intensive and is not continuous or universal. We will monitor hand hygiene compliance with a newly developed electronic system (MedSense, General Sensing Inc.). We will use the data to provide feedback to the staff in several ways. We hypothesise that comprehensive personalised feedback will reduce healthcare associated infections. We will undertake the study in three intensive care units.

Conditions

Cross Infection

Keywords

Critical care; Feedback

Outcome Measures

Primary Outcomes (1)

• Composite health care infection rate

  One of the following three: Bacteriological proven infection at a normally sterile site. The sterile sites vein considered are a prior defined as blood, broncho-alveolar lavage, urine sampled from a catheter, chest drain fluid, and surgical wounds. Blood cultures that grow normal skin commensals will be included Endotracheal secretions that culture organisms other than normal upper respiratory tract flora Clostridium difficult related diarrhoea

  Until the end of the second calendar day following ICU discharge

Secondary Outcomes (9)

• Incidence of central line associated blood stream infections

  Until the end of the second calendar day following ICU discharge

• Incidence of catheter associated urinary tract infections

  Until the end of the second calendar day following ICU discharge

• Incidence of ventilator associated pneumonia

  Until the end of the second calendar day following ICU discharge

• Incidence of surgical site infection

  Until the end of the second calendar day following ICU discharge

• Incidence of clostridium difficult diarrhoea

  Until the end of the second calendar day following ICU discharge

Other Outcomes (2)

• Staff attitudes to electronic compliance monitoring

  0 and 24 weeks

• Surrogate measures of hand hygiene compliance

  24 weeks

Study Arms (3)

ICU Cluster 1

Adult Intensive Care Unit - Royal Brompton Hospital

Other: Weekly poster of unit performance; Other: Daily email of personal feedback

ICU Cluster 2

Paediatric ICU - Royal Brompton Hospital

Other: Weekly poster of unit performance; Other: Daily email of personal feedback; Other: Active reminder from badge

ICU Cluster 3

Adult Intensive Care Unit - Harefield Hospital

Other: Weekly poster of unit performance; Other: Daily email of personal feedback; Other: Active reminder from badge

Interventions

Weekly poster of unit performance OTHER

Weekly feedback is provided to the ICU about current levels of hand hygiene compliance amongst doctors, nurses, and allied healthcare professionals

ICU Cluster 1; ICU Cluster 2; ICU Cluster 3

Daily email of personal feedback OTHER

Healthcare workers receive private and personal feedback via email regarding their individual performance benchmarked against the average performance for their professional grouping.

ICU Cluster 1; ICU Cluster 2; ICU Cluster 3

Active reminder from badge OTHER

The badge the healthcare worker is wearing vibrates if opportunities to perform hand hygiene are missed

ICU Cluster 2; ICU Cluster 3

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients admitted to the ICU during the study period.

You may qualify if:

• All patients admitted to the intensive care units
• All healthcare workers caring for the patients on the intensive care units.

You may not qualify if:

• Healthcare workers with skin sensitivity to both alcohol hand rub and soap

Sponsors & Collaborators

• Royal Brompton & Harefield NHS Foundation Trust: lead

Study Sites (1)

Royal Brompton and Harefield NHS Foundation Trust

London, United Kingdom

Location

Related Publications (1)

• Cheng VC, Tai JW, Ho SK, Chan JF, Hung KN, Ho PL, Yuen KY. Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology. BMC Infect Dis. 2011 May 26;11:151. doi: 10.1186/1471-2334-11-151.

  PMID: 21612666 BACKGROUND

MeSH Terms

Conditions

Cross Infection

Condition Hierarchy (Ancestors)

Infections; Iatrogenic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Patricia Cattini, MSc

  Royal Brompton and Harefield NHS Foundation Trust

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CROSSOVER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 26, 2013
• First Posted: July 30, 2015
• Study Start: November 1, 2013
• Primary Completion: July 1, 2014
• Study Completion: July 1, 2014
• Last Updated: July 30, 2015

Record last verified: 2015-07

Locations

GB (1)