05/23/10

To Assess the Effect of Camera Surveillance in To Assess the Effect of Camera Surveillance in Improving Compliance with Hand washing Improving Compliance with Hand washing

Practices in the ICU SettingPractices in the ICU Setting

Shallu Chauhan, Deepak AgrawalShallu Chauhan, Deepak AgrawalDepartment of Neurosurgery, JPNATC, AIIMS, N DelhiDepartment of Neurosurgery, JPNATC, AIIMS, N Delhi

05/23/10

BackgroundBackgroundHand washing has been shown to be the most effective means of reducing cross- infection in the health care environment. However, staff compliance remains low in the real world setting

05/23/10

AIMS & OBJECTIVESAIMS & OBJECTIVES

• To Asses the Effect of To Asses the Effect of Camera Surveillance in Camera Surveillance in Improving Compliance Improving Compliance with Hand washing with Hand washing Practices in the ICU Practices in the ICU Setting.Setting.

05/23/10

MATERIALS AND METHODSMATERIALS AND METHODS

• This was a prospective study carried out over one This was a prospective study carried out over one month period in one cubicle of neurosurgery month period in one cubicle of neurosurgery ICU.ICU.

• A surveillance camera which was previously A surveillance camera which was previously installed and functioning was focused on a installed and functioning was focused on a cubicle of three patients and recording of cubicle of three patients and recording of previous 24 hours was reviewed every day for 15 previous 24 hours was reviewed every day for 15 days.days.

• No of incidents in each shift duty were recordedNo of incidents in each shift duty were recorded

05/23/10

INCIDENTINCIDENTAn incident was defined as An incident was defined as

any one of the following:any one of the following:• Hand washing not done by Hand washing not done by

health team workers.health team workers.

• Touching different patients Touching different patients without hand washing.without hand washing.

• Using the same gloves for Using the same gloves for different patients and for different patients and for different procedures.different procedures.

• Hand washing not done after Hand washing not done after finishing the procedures.finishing the procedures.

05/23/10

MATERIALS AND METHODSMATERIALS AND METHODS

• Following, this 15 day period, all staff were Following, this 15 day period, all staff were verbally instructed in every shift that they were verbally instructed in every shift that they were under survellience for the next 15 days.under survellience for the next 15 days.

• Camera recordings of previous 24 hours were Camera recordings of previous 24 hours were similarly reviewed every day for these 15 days similarly reviewed every day for these 15 days and incidents recorded..and incidents recorded..

05/23/10

RESULTSRESULTS

First 15 days periodFirst 15 days period

• There were a total of 421 incidents (n) when There were a total of 421 incidents (n) when hand washing was not done.hand washing was not done.

• 84% (d=500) of the incidents occurred in the 84% (d=500) of the incidents occurred in the night shift especially during the early morning night shift especially during the early morning hours. hours.

05/23/10

RESULTSRESULTS

Subsequent 15 days periodSubsequent 15 days period(when the staff were informed that they were under camera surveillance)(when the staff were informed that they were under camera surveillance)

• The total number of events when hand washing The total number of events when hand washing was not done was 140.was not done was 140.

• Majority (90%) of the incidents occurred in the Majority (90%) of the incidents occurred in the night shift.night shift.

05/23/10

05/23/10

RESULTSRESULTS

• The difference The difference between the two between the two periods was periods was statistically highly statistically highly significant significant (p=57%). (p=57%).

05/23/10

STATISCAL ANALYSISSTATISCAL ANALYSIS

80%252019/7/09

11a.m to 4p.m

86%353018/7/09

6a.m to 11a.m

63%322017/7/09

5a.m to 10a.m

87%302616/7/09

4 a.m to 9 a.m

TOTAL % OF IMPROPER HEALTH PRACTISED HAS DONE IN THE I.C.U.[p]

TOTAL NUMBER OF EVENTS WHEN THE HEALTH TEAM MEMBERS HANDLED THE PATIENTS[d]

NUMBER OF EVENTS WHEN IMPROPER HEALTH PRACTISE HAS DONE[n]

DATE AND TIME

05/23/10

85%403420/7/09

2p.m to 8p.m

86%282421/7/09

4p.m to 9p.m

90%403622/7/09

6a.m to 11a.m

85%342923/7/09

10a.m to 1p.m

70%201424/7/09

10p.m to 1a.m

85%262225/07/09

4p.m to 8p.m

80%302426/7/09

2p.m to 8p.m

05/23/10

81%332727/7/09

11a.m to 5p.m

90%403628/7/09

6a.m to 11a.m

90%423829/7/09

5a.m to 1p.m

91%454130/7/09

5a.m to 1p.m

Staff is not aware of CCTVStaff is not aware of CCTV

05/23/10

Post AwarenessPost Awareness

TOTAL % OF IMPROPER HEALTH PRACTISED HAS

DONE IN THE I.C.U.

TOTAL NUMBER OF EVENTS WHEN THE HEALTH TEAM MEMBERS HANDLED THE PATIENTS [d]

NUMBER OF EVENTS WHEN IMPROPER HEALTH PRACTISE HAS

DONE [n]

DATE AND TIME

37%38143/08/09

6am to 11am

39%46182/08/09

4am to 2pm

50%40201/08/09

5am to 11am

05/23/10

26%38108/8/09

6a.m to 1p.m

31%34127/8/09

5a.m to 10a.m

19%4286/8/09

11p.m to 6a.m

26%2365/8/09

3p.m to 10p.m

28%36104/8/09

11a.m to 2p.m

05/23/10

23%3489/9/09

9a.m to 1pm

20%30610/9/09

3p.m to 7p.m

25%28711/9/09

8p.m to 12m.n

11%36417/9/09

4p.m to 10p.m

12%32414/9/09

11a.m to 4p.m

21%38813/9/09

5a.m to 11a.m

18%28512/9/09

4p.m to 8p.m

05/23/10

CONCLUSIONSCONCLUSIONS Hand washing is poorly Hand washing is poorly

practiced in our I.C.U. practiced in our I.C.U. set up by health set up by health personnel.personnel.

As the maximum As the maximum number of incidents number of incidents occur in the night shift, occur in the night shift, poor motivation may be poor motivation may be one of the factors for one of the factors for this behavior.this behavior.

05/23/10

Our study shows Our study shows that camera that camera

surveillance plays a surveillance plays a major role in major role in

changing the staff changing the staff behavior and may behavior and may

improve compliance improve compliance with hand washing.with hand washing.

05/23/10

THANKTHANK YOU YOU