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To assess the effect of camera surveillance in improving compliance with hand washing practices in the icu setting

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To assess the effect of camera surveillance in improving compliance with hand washing practices in the icu setting

  1. 1. To Assess the Effect of Camera Surveillance in Improving Compliance with Hand washing Practices in the ICU Setting Shallu Chauhan, Deepak Agrawal Department of Neurosurgery, JPNATC, AIIMS, N Delhi
  2. 2. Background <ul><li>. </li></ul>Hand 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
  3. 3. AIMS & OBJECTIVES <ul><li>To Asses the Effect of Camera Surveillance in Improving Compliance with Hand washing Practices in the ICU Setting. </li></ul>
  4. 4. MATERIALS AND METHODS <ul><li>This was a prospective study carried out over one month period in one cubicle of neurosurgery ICU. </li></ul><ul><li>A surveillance camera which was previously installed and functioning was focused on a cubicle of three patients and recording of previous 24 hours was reviewed every day for 15 days. </li></ul><ul><li>No of incidents in each shift duty were recorded </li></ul>
  5. 5. INCIDENT <ul><li>An incident was defined as any one of the following: </li></ul><ul><li>Hand washing not done by health team workers. </li></ul><ul><li>Touching different patients without hand washing. </li></ul><ul><li>Using the same gloves for different patients and for different procedures. </li></ul><ul><li>Hand washing not done after finishing the procedures. </li></ul>
  6. 6. MATERIALS AND METHODS <ul><li>Following, this 15 day period, all staff were verbally instructed in every shift that they were under survellience for the next 15 days. </li></ul><ul><li>Camera recordings of previous 24 hours were similarly reviewed every day for these 15 days and incidents recorded.. </li></ul>
  7. 7. RESULTS <ul><li>First 15 days period </li></ul><ul><li>There were a total of 421 incidents (n) when hand washing was not done. </li></ul><ul><li>84% (d=500) of the incidents occurred in the night shift especially during the early morning hours. </li></ul>
  8. 8. RESULTS <ul><li>Subsequent 15 days period </li></ul><ul><li>(when the staff were informed that they were under camera surveillance) </li></ul><ul><li>The total number of events when hand washing was not done was 140. </li></ul><ul><li>Majority (90%) of the incidents occurred in the night shift. </li></ul>
  9. 10. RESULTS <ul><li>The difference between the two periods was statistically highly significant (p=57%). </li></ul>
  10. 11. STATISCAL ANALYSIS 80% 25 20 19/7/09 11a.m to 4p.m 86% 35 30 18/7/09 6a.m to 11a.m 63% 32 20 17/7/09 5a.m to 10a.m 87% 30 26 16/7/09 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
  11. 12. 85% 40 34 20/7/09 2p.m to 8p.m 86% 28 24 21/7/09 4p.m to 9p.m 90% 40 36 22/7/09 6a.m to 11a.m 85% 34 29 23/7/09 10a.m to 1p.m 70% 20 14 24/7/09 10p.m to 1a.m 85% 26 22 25/07/09 4p.m to 8p.m 80% 30 24 26/7/09 2p.m to 8p.m
  12. 13. Staff is not aware of CCTV 81% 33 27 27/7/09 11a.m to 5p.m 90% 40 36 28/7/09 6a.m to 11a.m 90% 42 38 29/7/09 5a.m to 1p.m 91% 45 41 30/7/09 5a.m to 1p.m
  13. 14. Post 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% 38 14 3/08/09 6am to 11am 39% 46 18 2/08/09 4am to 2pm 50% 40 20 1/08/09 5am to 11am
  14. 15. 26% 38 10 8/8/09 6a.m to 1p.m 31% 34 12 7/8/09 5a.m to 10a.m 19% 42 8 6/8/09 11p.m to 6a.m 26% 23 6 5/8/09 3p.m to 10p.m 28% 36 10 4/8/09 11a.m to 2p.m
  15. 16. <ul><li>First CVP was monitored in patients with ventilatory support. </li></ul><ul><li>According to the standard norms of CVP measurement, CVP was monitored in all intubated patients in ICU. </li></ul><ul><li>With a time gap of 5 minutes, second reading was taken in same patients without ventilatory support. </li></ul>23% 34 8 9/9/09 9a.m to 1pm 20% 30 6 10/9/09 3p.m to 7p.m 25% 28 7 11/9/09 8p.m to 12m.n 11% 36 4 17/9/09 4p.m to 10p.m 12% 32 4 14/9/09 11a.m to 4p.m 21% 38 8 13/9/09 5a.m to 11a.m 18% 28 5 12/9/09 4p.m to 8p.m
  16. 17. CONCLUSIONS <ul><li>Hand washing is poorly practiced in our I.C.U. set up by health personnel. </li></ul><ul><li>As the maximum number of incidents occur in the night shift, poor motivation may be one of the factors for this behavior. </li></ul>
  17. 18. <ul><li>Our study shows that camera surveillance plays a major role in changing the staff behavior and may improve compliance with hand washing. </li></ul>
  18. 19. THANK YOU

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