Efficacy of covert closed-circuit television monitoring of the hand hygiene compliance of health care workers caring for patients infected with multidrug-resistant organisms in an intensive care unit

Ilana Livshiz-Riven, Leonid Koyfman, Ronit Nativ, Asaf Danziger, Alexander Shalman, Dmitry Frank, Boris Shvarts, Ofira Azulay, Evgeniya Ivanova, Tomer Ziv-Baran, Moti Klein, Matthew Boyko, Alexander Zlotnik, Abraham Borer, Evgeni Brotfain

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: To compare covert closed-circuit television (CCTV) monitoring to standard overt observation in assessing the hand hygiene (HH) conduct of health care workers (HCWs) caring for patients infected with multidrug-resistant organisms (MDROs). This was a cross-sectional study in a general intensive care unit of a 1,000-bed university hospital. Methods: Forty-six general intensive care unit HCWs (staff physicians, registered nurses, and auxiliary workers) caring for contact isolation MDRO-infected patients. The study incorporated the following 3 phases: phase 1, establishment of interrater reliability between 2 simultaneous observers using the overt observation method; phase 2, establishment of interrater reliability between 2 simultaneous observers using the CCTV method; and phase 3, simultaneous monitoring of HH by both methods to evaluate the suitability of CCTV as an alternative to direct observation of the HH conduct of HCWs caring for MDRO-infected patients. Results: Overall, 1,104 opportunities to perform HH were documented during 49 observation sessions. The compliance rate observed by the overt method (37.3%) was significantly higher than that observed when only the covert method was used (26.5%). However, simultaneous overt-covert observations were found to have intraclass correlation coefficients of >0.85. Conclusions: Covert CCTV observation of HCW HH compliance appears to provide a truer and more realistic picture than overt observation, probably because of its ability to neutralize the Hawthorne effect of overt observation. The high intraclass correlation coefficients between covert observation and overt observation supports this conclusion.

Original languageEnglish
Pages (from-to)517-521
Number of pages5
JournalAmerican Journal of Infection Control
Volume48
Issue number5
DOIs
StatePublished - 1 May 2020

Keywords

  • Contact Precautions
  • Infection Control
  • Validation

Fingerprint

Dive into the research topics of 'Efficacy of covert closed-circuit television monitoring of the hand hygiene compliance of health care workers caring for patients infected with multidrug-resistant organisms in an intensive care unit'. Together they form a unique fingerprint.

Cite this