Validity of hand hygiene compliance measurement by observation: A systematic review.
Am J Infect Control
; 47(3): 313-322, 2019 03.
Article
em En
| MEDLINE
| ID: mdl-30322815
ABSTRACT
BACKGROUND:
Hand hygiene is monitored by direct observation to improve practice, but this approach can potentially cause information, selection, and confounding bias, threatening the validity of findings. The aim of this study was to identify and describe the potential biases in hand hygiene compliance monitoring by direct observation; develop a typology of biases and propose improvements to reduce bias; and increase the validity of compliance measurements.METHODS:
This systematic review of hospital-based intervention studies used direct observation to monitor health care workers' hand hygiene compliance.RESULTS:
Seventy-one publications were eligible for review. None was free of bias. Selection bias was present in all studies through lack of data collection on the weekends (nâ¯=â¯61, 86%) and at night (nâ¯=â¯46, 65%) and observations undertaken in single-specialty settings (nâ¯=â¯35, 49%). We observed inconsistency of terminology, definitions of hand hygiene opportunity, criteria, tools, and descriptions of the data collection. Frequency of observation, duration, or both were not described or were unclear in 58 (82%) publications. Observers were trained in 56 (79%) studies. Inter-rater reliability was measured in 26 (37%) studies.CONCLUSIONS:
Published research of hand hygiene compliance measured by direct observation lacks validity. Hand hygiene should be measured using methods that produce a valid indication of performance and quality. Standardization of methodology would expedite comparison of hand hygiene compliance between clinical settings and organizations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Métodos Epidemiológicos
/
Pessoal de Saúde
/
Observação
/
Fidelidade a Diretrizes
/
Higiene das Mãos
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article