Adherence to contact precautions by different types of healthcare workers through video monitoring in a tertiary hospital. Issue 1 (September 2018)

• Record Type: Journal Article
• Authors: Katanami, Y.; Hayakawa, K.; Shimazaki, T.; Sugiki, Y.; Takaya, S.; Yamamoto, K.; Kutsuna, S.; Kato, Y.; Ohmagari, N.
• Is Part Of: Journal of hospital infection. Volume 100:Issue 1(2018)
• Page Start: 70
• Page End: 75
• Publication Date: 2018-09
• Subjects: Personal protective equipment -- Contact precautions -- Adherence -- Multi-drug-resistant organisms -- Video monitoring; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2018.01.001
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Background: Contact precautions are required to prevent transmission of multi-drug-resistant organisms; however, reports on adherence rates vary. This study used video monitoring to evaluate adherence to the use of personal protective equipment (PPE) by different types of healthcare workers. Methods: This observational study was conducted in a 781-bed tertiary hospital from July 2016 to March 2017. Cameras were installed in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates. Results: In total, 1097 opportunities for donning PPE were observed. Most staff observed were nurses and nursing assistants (Ns/Nsas) (880/1097, 80.2%). Overall, the adherence rate to appropriate PPE use was 34.0%. The adherence rate among Ns/Nsas was lower (239/858, 27.9%) compared with infectious disease doctors (18/18, 100%) and cleaning staff (42/49, 85.7%). The adherence rate for PPE use for Clostridium difficile infection (CDI) with toxin detection was significantly higher than that for CDI without toxin detection and multi-drug-resistant organisms ( P <0.001 for both). The adherence rate for patients with an independent functional status was higher than that for patients with a dependent functional status ( P =0.018). The adherence rate was lower in the intensive care unit (ICU) than in non-ICU wards (27.6% vs 36.5%; P =0.006). Conclusion: Video monitoring is a useful tool for monitoring adherence to PPE use, facilitating observation of more PPE opportunities than direct observation. Adherence to contact precautions varied by occupation; however, overall adherence was insufficient. The lower adherence rate in nurses might be due to more frequent care visits.