| Popis: |
Hand hygiene (HH) is recognised as the most important thing a healthcare worker (HCW) can do to prevent healthcare associated infection. Practice is audited according to the WHO 5 Moments for HH and while direct human observation is considered the gold standard method, questions regarding utility have arisen. Various electronic systems have been suggested, however most use proxy measures. Video-based systems (VMS) offer possibilities in that compliance can be ascertained according to the WHO 5 Moments framework. However, this has yet to be explored via systematic, sustained research. This thesis explored the utility of VMS as a method of HH auditing via pragmatic, mixed-methods research across 3 interconnected studies. Study 1 explored the technical and methodological specifications that might be required of a VMS. Study 2 examined the feasibility and time efficiency of VMS approaches via a trial. Study 3 unearthed the acceptability of VMS methods for HH auditing to HCWs and patients. This study reveals the utility of VMS for auditing according to the WHO 5 Moments. It offers technical and methodological specifications for effective and efficient data collection and demonstrates VMS auditing is more time efficient. The literature suggested acceptability for HCWs and patients could be a potential barrier to the use within the patient zone, however, this thesis has demonstrated that this was not the case provided certain technical and methodological features and protections are in place. HCWs could see the advantages of the approach in relation to time efficiency, but expressed fears in terms of negative feedback or punitive consequences. A variety of legislative issues relating to privacy, consent, legal status of footage, retention and deletion and open disclosure would need to be taken into consideration. Future research should undertake in vivo experimentation of the technology and methodology. |
