Establishing a Learning Model for Correct Hand Hygiene Technique in a NICU

J Clin Med. 2022 Jul 22;11(15):4276. doi: 10.3390/jcm11154276.

Abstract

The ability of healthcare workers to learn proper hand hygiene has been an understudied area of research. Generally, hand hygiene skills are regarded as a key contributor to reduce critical infections and healthcare-associated infections. In a clinical setup, at a Neonatal Intensive Care Unit (NICU), the outcome of a multi-modal training initiative was recorded, where objective feedback was provided to the staff. It was hypothesized that staff at the NICU are more sensitive towards applying increased patient safety measures. Outcomes were recorded as the ability to cover all hand surfaces with Alcohol-Based Handrub (ABHR), modelled as a time-series of measurements. The learning ability to rub in with 1.5 mL and with 3 mL was also assessed. As a secondary outcome, handrub consumption and infection numbers were recorded. It has been observed that some staff members were able to quickly learn the proper hand hygiene, even with the limited 1.5 mL, while others were not capable of acquiring the technique even with 3 mL. When analyzing the 1.5 mL group, it was deemed an insufficient ABHR amount, while with 3 mL, the critical necessity of skill training to achieve complete coverage was documented. Identifying these individuals helps the infection control staff to better focus their training efforts. The training led to a 157% increase in handrub consumption. The setting of the study did not allow to show a measurable reduction in the number of hospital infections. It has been concluded that the training method chosen by the staff greatly affects the quality of the outcomes.

Keywords: NICU infection prevention; SSI prevention; evidence-based hand hygiene; hand hygiene training.

Grants and funding

The authors gratefully acknowledge the support of HandInScan Zrt., providing the Semmelweis Scanner and the technical background for the study. HARTMANN-RICO Hungária Kft. is recognized for their support with the training solution. This project has been partially supported by the National Research, Development, and Innovation Fund of Hungary, financed under the TKP2021-NKTA-36 funding scheme (Development and evaluation of innovative and digital health technologies—Evaluation of digital medical devices: efficacy, safety, and social utility).