看護とケアのジャーナル

Hand Hygiene Analyzed by Video Recording

Abstract

Sophia Boudjema, Pauline Reynier, Jean Charles Dufour, Olga Florea, Philippe Patouraux, Patrick Peretti-Watel and Philippe Brouqui*

Objective : The aim of this study is to evaluate the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares.

Methods : In an infectious diseases care unit of a university hospital in Marseille, France, we designed an observational study at evaluating the hand hygiene and isolation precaution adhesion of the healthcare workers in routine cares by remote video recording. The care team including nurses, assistant nurses, housekeepers and physicians was monitored from November 30th (2012) to February 13th (2013). From a video camera was placed inside patient room, healthcare workers paths were recorded from entrance to exit of the patient’s room. Hand hygiene disinfection as well as gloves and mask wearing in isolation precautions were observed. A video camera was placed inside patient room. Healthcare workers paths were recorded from entrance to exit of the patient’s room. A nurse and a sociologist analyzed further videos. Hand hygiene disinfection as well as gloves and mask wearing in isolation precaution were observed.

Results : A total of 756 videos were captures. 249 were rejected because they were not contributive and 507 videos (811 Healthcare workers paths) were analyzed. Healthcare workers had hand disinfection at least one time in the path in 28.2%. Hand disinfection at entrance and exit of the bedroom is respected in 6.2%. The meal tray delivery is associated with a lower hand hygiene practice. The glove wearing adhesion is 51.2% in Clostridium difficile contact precaution, and conformity to protocol is 17.5%. Wearing gloves impairs hand disinfection especially in situation where gloves are not part of the protocol (38.7%). Adhesion to mask wearing in airborne precaution is 90.7%.