A human factors engineering approach to improving hand hygiene quality
Healthcare-associated infections (HAIs) are common and expensive complications that can occur during inpatient hospital stays. Hand hygiene (HH)—which includes hand washing with soap and water and hand rubbing with alcohol-based hand sanitizer—is the primary tool used by healthcare personnel (HCP) t...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Human Factors in Healthcare |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772501424000216 |
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| author | Michael W. Boyce Trini A. Mathew Scott C. Roberts Michael Aniskiewicz Kathy Krechevsky Suzanne Dahlberg Noelle Frye Jamie E. Trumpler Leigh V. Evans Richard A. Martinello |
| author_facet | Michael W. Boyce Trini A. Mathew Scott C. Roberts Michael Aniskiewicz Kathy Krechevsky Suzanne Dahlberg Noelle Frye Jamie E. Trumpler Leigh V. Evans Richard A. Martinello |
| author_sort | Michael W. Boyce |
| collection | DOAJ |
| description | Healthcare-associated infections (HAIs) are common and expensive complications that can occur during inpatient hospital stays. Hand hygiene (HH)—which includes hand washing with soap and water and hand rubbing with alcohol-based hand sanitizer—is the primary tool used by healthcare personnel (HCP) to prevent HAIs. Consequently, the World Health Organization (WHO) proposed guidelines for effective HH in healthcare settings. However, consistent performance of HH by HCP is still lacking. HH in healthcare requires both compliance with indications for HH and quality of HH. Integrative approaches in human factors engineering (HFE) and infection prevention can be used to promote sustainable techniques that can be implemented by HCP to improve the quality of HH techniques. This research proposes a three-phase integrative approach that uses HFE-based methods to identify why HH is often insufficiently executed by HCP in hospital settings and ultimately to help guide HCP to improve HH quality. We performed i) a tabular task analysis (TTA), constructed by HFE personnel and infection prevention specialists, ii) card sorting with infection prevention subject matter experts to prioritize HH steps and analyzed with criticality analysis and subsequent modifications to the TTA, and iii) TTA validation and verification with subject matter experts. Finally, we conducted qualitative interviews with members of hospital leadership and determined that it is feasible to implement the use of TTAs in hospital settings. This research provides enhanced HH guidance using an integrative HFE-based approach and is directed to increase the quality of HH performed by HCP, thereby reducing HAI rates and improving patient safety. Furthermore, these results can be used to support the effective implementation of the WHO's HH guidance. Our findings elucidate some of the challenges to patient safety regarding HH and clarify best practices for HH in hospital settings. |
| format | Article |
| id | doaj-art-9d72bbbaebba4a8cb97ac790b74e16ba |
| institution | OA Journals |
| issn | 2772-5014 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Human Factors in Healthcare |
| spelling | doaj-art-9d72bbbaebba4a8cb97ac790b74e16ba2025-08-20T02:32:20ZengElsevierHuman Factors in Healthcare2772-50142024-12-01610008510.1016/j.hfh.2024.100085A human factors engineering approach to improving hand hygiene qualityMichael W. Boyce0Trini A. Mathew1Scott C. Roberts2Michael Aniskiewicz3Kathy Krechevsky4Suzanne Dahlberg5Noelle Frye6Jamie E. Trumpler7Leigh V. Evans8Richard A. Martinello9Department of Emergency Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA; Center for Healthcare Simulation, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USA; Corresponding Author.HealthTAMCycle3 PLLC, Troy, MI 48085, USADepartment of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA; Department of Infection Prevention, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USADepartment of Infection Prevention, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USADepartment of Infection Prevention, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USADepartment of Infection Prevention, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USAGrant Resources Office, Yale New Haven Heath, 730 Howard Ave., New Haven, CT 06519, USAGrant Resources Office, Yale New Haven Heath, 730 Howard Ave., New Haven, CT 06519, USADepartment of Emergency Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA; Center for Healthcare Simulation, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USADepartment of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA; Department of Infection Prevention, Yale New Haven Health, 730 Howard Ave., New Haven, CT 06519, USA; Department of Pediatrics, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USAHealthcare-associated infections (HAIs) are common and expensive complications that can occur during inpatient hospital stays. Hand hygiene (HH)—which includes hand washing with soap and water and hand rubbing with alcohol-based hand sanitizer—is the primary tool used by healthcare personnel (HCP) to prevent HAIs. Consequently, the World Health Organization (WHO) proposed guidelines for effective HH in healthcare settings. However, consistent performance of HH by HCP is still lacking. HH in healthcare requires both compliance with indications for HH and quality of HH. Integrative approaches in human factors engineering (HFE) and infection prevention can be used to promote sustainable techniques that can be implemented by HCP to improve the quality of HH techniques. This research proposes a three-phase integrative approach that uses HFE-based methods to identify why HH is often insufficiently executed by HCP in hospital settings and ultimately to help guide HCP to improve HH quality. We performed i) a tabular task analysis (TTA), constructed by HFE personnel and infection prevention specialists, ii) card sorting with infection prevention subject matter experts to prioritize HH steps and analyzed with criticality analysis and subsequent modifications to the TTA, and iii) TTA validation and verification with subject matter experts. Finally, we conducted qualitative interviews with members of hospital leadership and determined that it is feasible to implement the use of TTAs in hospital settings. This research provides enhanced HH guidance using an integrative HFE-based approach and is directed to increase the quality of HH performed by HCP, thereby reducing HAI rates and improving patient safety. Furthermore, these results can be used to support the effective implementation of the WHO's HH guidance. Our findings elucidate some of the challenges to patient safety regarding HH and clarify best practices for HH in hospital settings.http://www.sciencedirect.com/science/article/pii/S2772501424000216Hand hygieneInfection control, Human factors engineeringCenters for disease control and preventionWorld health organization |
| spellingShingle | Michael W. Boyce Trini A. Mathew Scott C. Roberts Michael Aniskiewicz Kathy Krechevsky Suzanne Dahlberg Noelle Frye Jamie E. Trumpler Leigh V. Evans Richard A. Martinello A human factors engineering approach to improving hand hygiene quality Human Factors in Healthcare Hand hygiene Infection control, Human factors engineering Centers for disease control and prevention World health organization |
| title | A human factors engineering approach to improving hand hygiene quality |
| title_full | A human factors engineering approach to improving hand hygiene quality |
| title_fullStr | A human factors engineering approach to improving hand hygiene quality |
| title_full_unstemmed | A human factors engineering approach to improving hand hygiene quality |
| title_short | A human factors engineering approach to improving hand hygiene quality |
| title_sort | human factors engineering approach to improving hand hygiene quality |
| topic | Hand hygiene Infection control, Human factors engineering Centers for disease control and prevention World health organization |
| url | http://www.sciencedirect.com/science/article/pii/S2772501424000216 |
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