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J Hosp Infect. 2018 Sep;100(1):70-75. doi: 10.1016/j.jhin.2018.01.001. Epub 2018 Jan 6.

Adherence to contact precautions by different types of healthcare workers through video monitoring in a tertiary hospital.

Author information

1
Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan. Electronic address: yuichi.katanami@gmail.com.
2
Disease Control and Prevention Centre, National Centre for Global Health and Medicine, Tokyo, Japan.
3
Infection Control and Prevention, National Centre for Global Health and Medicine, Tokyo, Japan.

Abstract

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.

KEYWORDS:

Adherence; Contact precautions; Multi-drug-resistant organisms; Personal protective equipment; Video monitoring

PMID:
29317259
DOI:
10.1016/j.jhin.2018.01.001
[Indexed for MEDLINE]

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