A Cluster Randomized Trial of Immediate Hand Hygiene Compliance Feedback
Notice bibliographique
Résumé
Background. Multimodal interventions including audit and feedback can improve hand hygiene compliance (HHC). Immediate, rather than periodic (e.g. monthly), feedback may result in further improvement. Methods. We conducted a cluster randomized controlled trial (RCT) of immediate feedback on 16 wards of a tertiary care hospital in Toronto, Canada. At baseline, all wards received monthly feedback on HHC. Units were randomized within pairs determined by baseline HHC over 1 year. Audits without feedback were performed 2 times/week on both control and intervention wards. Additionally, 2 feedback audits were performed weekly on intervention wards. During feedback audits, the auditor provided feedback on HH events and missed HH opportunities. After 10 weeks, feedback was initiated on the control units and stopped on the intervention units (i.e. crossed-over). A comparison of non-feedback audits between the intervention and control units was the primary outcome. Feedback audits were not included because we anticipated that there would be an increase HHC during feedback audits due to increased observation bias (i.e. Hawthorne effect). If immediate feedback resulted in sustained behavior change, improvements in HHC should be seen during the non-feedback audits on the intervention wards. Results. Baseline HHC was 65% and 67% for the intervention and control wards. Overall, 14,527 HH opportunities were observed, 9215 during the baseline period, 3161 during the intervention period, and 2151 during the cross-over period. HHC on the intervention wards did not change between the baseline and intervention phase (65% versus 65%) while HHC on the control wards increased 2% (67% to 69%). When both feedback and non-feedback audits are included, a 6% increase was observed on the intervention wards versus 2% on the control wards. This difference occurred because of a 6% increase in HHC on the intervention unit during the feedback versus non-feedback audits (71% versus 65%). Results. from the cross-over period were similar, with no substantial benefit to feedback seen but with persistent evidence of observation bias. Conclusion. We failed to identify any increase in HHC following the initiation of immediate feedback in a cluster RCT. Compliance was 6% higher during feedback versus non-feedback audits, likely due to an increase in observation bias. Disclosures. All authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».