Becker's Clinical Quality & Infection Control

25 INFECTION CONTROL & PATIENT SAFETY Hawthorne Effect Influences Hand Hygiene Rates, New Study Shows By Brian Zimmerman W hen healthcare professionals are aware they're being observed, they're significantly more likely to comply with hand hygiene guidelines, accord- ing to a study presented at the 43rd Annual Conference of the Association for Professionals in Infection Control and Epidemiology held in Charlotte, N.C. For the study, the infection prevention department at San- ta Clara Valley Medical Center in San Jose, Calif., collected 4,640 observations between July 2015 and December 2015. The observations were made by five infection pre- vention nurses whose presence was known to staff and 15 hospital volunteers whom the staff was unaware of. Researchers found that when providers were aware of be- ing observed, they were 30 percent more likely to comply with hand hygiene recommendations. The reactive social mechanism at play in the study is known as the Hawthorne effect — a social occurrence in which individuals alter or improve their behavior in response to their awareness of being observed. The study's results suggest this effect can hinder accurate hand hygiene observation in healthcare settings. "This was not a result that we expected to see," said Nancy Johnson, infection prevention manager at Santa Clara Valley Medical Center. "We have rolled out many changes as a result, including an organization- wide hand hygiene improvement plan that is actively supported by our leadership team. Moving forward, the medical center's monitoring will be conducted by unknown observers." n Body-Worn Hand Hygiene System Increases Hand Decontamination By Shannon Barnet D artmouth-Hitchcock Medical Center in Lebanon, N.H., and the University of Massachusetts Memorial Medical Center in Worchester tested a novel body-worn hand hygiene sys- tem in a new study published in Infection Control & Hospital Epidemiology. To explore the efficacy of the system, the researchers randomly assigned operat- ing room environments to either the usual intraoperative hand hygiene method or the personalized, body-worn hand hygiene system. They also monitored and reported hourly hand decontamination events for anesthesia and circulating nurse staff mem- bers. All total, more than 3,250 OR environments and patients were enrolled in the trial. Ultimately, the study revealed the staff members with the body-worn system achieved a hand decontamination event rate of 4.3 events per hour. Meanwhile, staff members in the control group who used conventional, wall-mount- ed hand hygiene devices achieved a hand decontami- nation event rate of only 0.57 events per hour. Although the novel sys- tem was associated with an increase in hand hygiene com- pliance, it was not associated with a decrease in the num- ber of 30-day postoperative healthcare-associated infec- tions reported by patients. "Future work is indicated to op- timize the efficacy of this hand hygiene improvement strate- gy," the authors concluded. n Gloves Transfer Bacteria Between Hospital Surfaces, Study Finds By Max Green A lthough healthcare workers use gloves to protect both patients and themselves from bacterial contamination, new research suggests gloves themselves may play a significant role in transferring bugs between hospital surfaces. Clinicians from the Nippon Medical School in Bunkyo, Japan, presented data at a June 19 American Society for Microbiology conference in Boston that looked at cross-contamination rates for nitrile examination gloves by introducing bacteria to gloves then measuring the residue they le on sterile surfaces. Of the bacteria tested, including Acinetobacter baumannii, E. coli, Klebsiella pneuomoniae and Pseudomonas aeruginosa, only A. bau- mannii remained on the surfaces. "is study shows that contaminated gloves increase risks of cross-transmission of healthcare-associated pathogens among healthcare workers and in the environment," Sae Otani, author of the study, said in a statement. Failing to remove or change contaminated gloves carries a higher risk of transmitting bacteria that cause hospital-acquired infections, the authors concluded. n

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