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Topic 9 ethical considerations


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Topic 9 ethical considerations

  1. 1. Topic 9: Are there any ethicalconsiderations to be made?Ethical considerations in collectingthe data... (bias in the data)
  2. 2. What is Bias?“...a systematic deviation of a study’s result from a true value that is usually introduced during the design or implementation of a study and cannot be corrected after the fact.” (The Joint Commission, 2009, p. 87).
  3. 3. “data from poor tools can be misleading anddangerous.”Expressing concern about data collectionmethods, John Boyce, M.D., section chief ofInfectious Diseases and director of the HandHygiene Resource Center at the Hospital of SaintRaphael in New Haven, Connecticut.
  4. 4. “ a tool used as a standard for hand hygiene monitoring but providing inaccurate data could produce a false sense of security among health care workers and, therefore, could be counterproductive.” Professor Didier Pittet, M.D., M.S., director, Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland, and leader, WHO First Global Patient Safety Challenge.
  5. 5. Ethical Principles• Autonomy• Beneficence• Justice
  6. 6. Observer Bias...• “...the extent to which the observer inaccurately identifies or measures a phenomenon” (The Joint Commission, 2009, p. 87).
  7. 7. Data is gathered by more than oneresearcher...• Bias could take the form of the position of the data collector• employed by the organisation or not• amount of effort put into the data collection
  8. 8. Staffing issues...• Use of infection preventionists, quality improvement staff, and other health care workers• Time management• Whether it is worth the effort? o_7652163_professional- hospital-staff-working-on-a- note-pad-together.html
  9. 9. Use of outside staff• Recommended by the Joint Commission’s report• Funding will need to be found• Time consuming
  10. 10. Use of technology to eliminate bias• Unobtrusive• Less selection bias• Range of cameras often limited• Can be expensive and time consuming• Privacy of the patients and staff
  11. 11. Privacy Considerations• WHO’s Manual for Observers:“Observation does not justify infringing the principle of patient privacy. This means observers show discretion regarding where they place themselves and their movements.”• Ontario’s hand hygiene program’s instructions for observers state, “The observer must conduct observations openly, without interfering with the ongoing work, and keep the identity of the healthcare providers confidential.”
  12. 12. WHO “Clean care is safer care”5-part multimodal hand hygiene improvement strategy:• Structural system changes, such as making alcohol based hand rub available at the point of care• Training and education• Observation of hand hygiene performance and feedback• Reminders in the workplace• Creation of a safety culture
  13. 13. WHO recommended observation tool• Included in the WHO “Guide for Implementation” toolkit• Collects data at the level of each hand hygiene opportunity• Used as a model in more than 25 countries including Australia, Canada and the UK.