Internet of Things to Explore Moment 2 of “WHO My Five Moments” for Hand Hygiene
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SUBMITTER: Florea O
PROVIDER: S-EPMC8566730 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:To evaluate the effectiveness of a brief mindfulness intervention on hand hygiene performance and mindful attention for inpatient physician teams. DESIGN:A pilot, pre-test/post-test randomised controlled mixed methods trial. SETTING:One academic medical centre in the USA. PARTICIPANTS:Four internal medicine physician teams consisting of one attending, one resident, two to three interns and up to four medical students. INTERVENTION:A facilitated, group-based educational discussion on how mindfulness, as practised through mindful hand hygiene, may improve clinical care and practices in the hospital setting. MAIN OUTCOMES AND MEASURES:The primary outcome was hand hygiene adherence (percentage) for each patient encounter. Other outcomes were observable mindful moments and mindful attention, measured using the Mindfulness Attention Awareness Scale, from baseline to post-intervention, and qualitative evaluation of the intervention. RESULTS:For attending physicians, hand hygiene adherence increased 14.1% in the intervention group compared with a decrease of 5.7% in the controls (P=0.035). For residents, the comparable figures were 24.7% (intervention) versus 0.2% (control) (P=0.064). For interns, adherence increased 10.0% with the intervention versus 4.2% in the controls (P=0.007). For medical students, adherence improved more in the control group (4.7% intervention vs 7.7% controls; P=0.003). An increase in mindfulness behaviours was observed for the intervention group (3.7%) versus controls (0.9%) (P=0.021). Self-reported mindful attention did not change (P=0.865). CONCLUSIONS:A brief, education-based mindfulness intervention improved hand hygiene in attending physicians and residents, but not in medical students. The intervention was well-received, increased mindfulness practice, and appears to be a feasible way to introduce mindfulness in the clinical setting. Future work instructing clinicians in mindfulness to improve hand hygiene may prove valuable. TRIAL REGISTRATION NUMBER:NCT 03165799; Results.
| S-EPMC6701174 | biostudies-literature
Project description:BackgroundHand hygiene is universally recognized as a cornerstone measure for the prevention of healthcare-associated infections. Although the WHO "My five Moments for hand hygiene" poster has been used for more than a decade to delineate hand hygiene indications and promote action, adherence levels among healthcare workers are still notoriously low and disquieting. To compensate for the lack of effective hand hygiene communication, we aimed to evaluate emojis as possible surrogates for the non-verbal aspects of hand hygiene behaviour.MethodsFollowing a thorough review of the Unicode version 12.0, the most applicable emojis to the terms used in the WHO 5 Moments poster were extracted. We developed a self-administered questionnaire to assess the view of infection prevention and control (IPC) practitioners regarding the use of emojis to show the WHO 5 Moments. Completed questionnaires were collected and analysed to determine the suitability of the existing emojis to illustrate a unified emoji poster. Data were analysed using R (version 3.6.3).ResultsA total of 95 IPC practitioners completed the questionnaire from May to October 2019 from different countries. Of these, 69 (74%) were female, and the mean age of the participants was 44.6 ± 10.87 years. We found appropriate emojis for six of the words used in the poster, including for touching (72%), for patient (63%), for clean (53%), for procedure (56%), for body fluid (58%), and for exposure risk (71%). The existing emojis proposed for the words "hygiene", "aseptic", and "surrounding" seemed to be less satisfactory.ConclusionsIn summary, the findings of this study indicate that the existing emojis may not be able to substitute the words used in the WHO 5 Moments poster. Emojis might be helpful to address hand hygiene indications in healthcare that may eventually play a role in promoting this measure. However, emojis should be further studied to choose the most appropriate ones and avoid ambiguity and misinterpretation. More emojis to convey health related messages are needed. We recommend further research in this area to evaluate the effect of using emojis in healthcare-related behaviours.
| S-EPMC9607812 | biostudies-literature
Project description:BackgroundThe World Health Organization have designed the fifth of their '5 moments' for hand hygiene to account for microbial transfer from patients to equipment in a narrow area around that patient, known as the patient zone. The study was prompted by emerging local confusion about application of the patient zone in the operating room (OR).Aim/objectivesIn two phases, we aimed to create a '5 moments' style poster displaying an OR patient zone: phase 1, quantify equipment, in direct contact with the patient and, touched by non-scrubbed staff immediately after touching the patient; and phase 2, categorise equipment identified in phase 1 into patient zone and healthcare zone. An objective is to produce a '5 moments' poster for the OR.MethodsThe first phase used non-participant direct overt observation. In phase 2, phase 1 data were collaboratively assigned to patient zone or healthcare zone. Photography and graphic design were used to produce the OR '5 moments' poster.ResultsIn 11 full-length surgeries, 20 pieces of equipment were in direct contact with the patient and 57 pieces of equipment were touched. In phase 2, a '5 moments' poster showing an OR patient zone was designed.DiscussionContent of the patient zone was identified and displayed in a novel resource. Having shared understanding of the patient zone has potential to sustain hand hygiene compliance and equipment cleaning in the OR.ConclusionLimitations in methods were balanced by collaboration with frontline staff. The study has been used as a teaching tool in the OR and similar settings.
| S-EPMC6978567 | biostudies-literature
Project description:BackgroundHandwashing is a key strategy for reducing the spread of infection but hand hygiene practises are often poor. Pre-testing messages prior to a campaign is expensive and time consuming.ObjectiveThis study investigates (1) emotional reactions to handwashing messages based on four different theoretical constructs (Knowledge of Risk, Comfort, Disgust and Social Norms), (2) how images may influence emotional reactions and (3) the influence of emotion, images and theoretical construct on handwashing motivation.MethodsA novel methodology was employed whereby FaceReader, software that automatically analyses emotions, was used to identify reactions to handwashing messages. Thirty-one participants from The University of Sheffield were recruited for this laboratory study.ResultsMost participants did not react strongly to any message and emotional reactions were similar for messages from different theoretical constructs. Adding images to text messages intensified some emotional reactions, particularly Happy and Disgusted for the two messages from the Disgust theoretical perspective. Moreover, participants thought that messages that used images were 1.8 times more likely to encourage handwashing. Knowledge of Risk messages (most encouraging) were 2.9 times more likely to be selected as encouraging handwashing than Comfort messages (least encouraging). An increase in the Disgusted emotion was also associated with an increase in encouragement.DiscussionThis study suggests that handwashing messages should be designed to exploit emotional reactions but more research is needed to understand how to design messages for these reactions. Whether disgust is as important post Covid-19 requires future investigation. FaceReader can be usefully and inexpensively employed to pre-test handwashing messages.
| S-EPMC9052853 | biostudies-literature
Project description:Neurologists have a new toolbox of options for neurorehabilitation of disabling brain disorders such as stroke and traumatic brain injury. An emerging intellectual paradigm for neurologic recovery that includes neural regeneration, repair, and dynamic reorganization of functional neural systems, as well as increasing awareness of behavioral principles that may support best return to function and freedom, brought forward treatments based on experience-dependent learning, neurophysiologic stimulation, and a combination of these concepts. In this article, we summarize five rehabilitative approaches to watch: constraint therapy for motor and language recovery, synergy of motor-language rehabilitation, prism adaptation training and other virtual feedback approaches, and noninvasive magnetic and electrical brain stimulation.
| S-EPMC3863977 | biostudies-literature
Project description:Corticobasal syndrome (CBS) is characterized by asymmetric involuntary movements including rigidity, tremor, dystonia, and myoclonus, and often associated with apraxia, cortical sensory deficits, and alien limb phenomena. Additionally, there are various nonmotor (cognitive and language) deficits. CBS is associated with several distinct histopathologies, including corticobasal degeneration, other forms of tau-related frontotemporal lobar degeneration such as progressive supranuclear palsy, and Alzheimer disease. Accurate antemortem diagnosis of underlying pathology in CBS is challenging, though certain clinical and imaging findings may be helpful. Five recent advances in the understanding of CBS are reviewed, including clinical and pathologic features, imaging and CSF biomarkers, the role of specific genes, and the concept of a spectrum of tauopathies.
| S-EPMC4160446 | biostudies-literature
Project description:Recent reports herald important advances in our understanding and management of gliomas. A role for alkylator chemotherapy in the management of certain high-grade gliomas has been confirmed and linked to specific, clinically ascertainable molecular markers. Magnetic resonance spectroscopy can now image 2-hydroxyglutarate, an oncometabolite restricted to the three-quarters of low-intermediate grade gliomas harboring an isocitrate dehydrogenase gene mutation; this has powerful implications for diagnosis and assessment of response to therapies. Genome-wide association studies point to several SNPs conveying increased risk of glioma; further studies of the involved genes and RNA products will enhance our understanding of glioma development. Finally, high-throughput sequencing has identified novel mutations in a histone-coding gene and in genes related to the histone complex in pediatric glioblastoma.
| S-EPMC3787111 | biostudies-literature
Project description:Purpose of reviewTo present emerging issues in neurometabolic disorders, with an emphasis on the diagnostic workup of patients with suspected neurometabolic disorders and some future challenges in the care for these patients.Recent findingsNext-generation sequencing and next-generation metabolic screening increase the speed and yield of the diagnostic process in neurometabolic disorders. Furthermore, they deepen our insights into the underlying disease mechanisms. Care of adult patients with neurometabolic disorders is an expanding subspecialty, especially in internal medicine and neurology.SummaryWe briefly discuss some novel genetic and biochemical laboratory techniques and changing insights in the molecular basis of disease, and illustrate the importance of MRI pattern recognition in the diagnostic process. Furthermore, we discuss gene therapy that is cautiously entering the field, and pay attention to the new field of (transition of) care for adult patients with inborn errors of metabolism.
| S-EPMC5727707 | biostudies-literature
Project description:The German "Clean Hands Campaign" (an adaptation of the WHO "Clean Care is Safer Care" programme) to promote hand hygiene among hospital personnel at Hannover Medical School (MHH, Medizinische Hochschule Hannover), known as Aktion Saubere Hände (ASH), met with initial success. By 2013, however, compliance rates with hygienic hand disinfection in the hospital's ten intensive care units (ICUs) and two hematopoietic stem cell transplantation units (HSCTUs) had relapsed to their initial levels (physicians: 48%; nurses: 56%). The cluster- randomized controlled trial PSYGIENE was conducted to investigate whether interventions tai - lored in ways suggested by research in behavioral psychology might bring about more sustainable improvements than the ASH.The "Health Action Process Approach" (HAPA) compliance model specifies key psychological determinants of compliance. These determinants were assessed among health care workers in the ICUs and HSCTUs of the MHH by questionnaire (response rates: physicians: 71%; nurses: 63%) and by interviews of the responsible ward physicians and head nurses (100%). In 2013, 29 tailored behavior change techniques were implemented in educational training sessions and feedback discussions in the six wards that constituted the intervention arm of the trial, while ASH training sessions were provided in the control arm. The compliance rates for 2014 and 2015 (the primary outcomes of the trial) were determined by nonparticipating observation of hygienic hand disinfection, in accordance with the World Health Organization's gold standard.The two groups did not differ in their baseline compliance rates in 2013 (intervention: 54%, control: 55%, p = 0.581). The tailored interventions led to increased compliance in each of the two follow-up years (2014: 64%, p<0.001; 2015: 70%, p = 0.001), while the compliance in the control arm increased to 68% in 2014 (p<0.001) but fell back to 64% in 2015 (p = 0.007). The compliance increases from 2013-2015 and the compliance rate in 2015 were higher in the intervention arm (p<0.005). This was mainly attributable to the nurses' behavior, as the corresponding parameters for physicians did not differ significantly between the two study arms in stratified analysis.Tailored interventions based on behavioral psychology principles led to more sustainable increases in compliance with hand hygiene guidelines than ASH training sessions did. This was true among nurses, and thus also for hospital ward personnel as a whole (i.e., nurses and physicians combined). Further studies are needed to identify more target group-specific interventions that may improve compliance among physicians.
| S-EPMC5551068 | biostudies-other
Project description:There is a significant increase in the geriatric population across the globe. With the increase in the number of geriatric people and their associated health issues, the need for larger healthcare resources is inevitable. Because of this, healthcare service-providing industries are facing a severe challenge. However, technological advancement in recent years has enabled researchers to develop intelligent devices to deal with the scarcity of healthcare resources. In this regard, the Internet of things (IoT) technology has been a boon for healthcare services industries. It not only allows the monitoring of the health parameters of geriatric patients from a remote location but also lets them live an independent life in a cost-efficient way. The current paper provides up-to-date comprehensive knowledge of IoT-based technologies for geriatric healthcare applications. The study also discusses the current trends, issues, challenges, and future scope of research in the area of geriatric healthcare using IoT technology. Information provided in this paper will be helpful to develop futuristic solutions and provide efficient cost-effective healthcare services to the needy.
| S-EPMC8313366 | biostudies-literature