Evidence map›Paper›PMID 32943340›Full record

Observational studyJournal of the American Medical Directors Association2021

Observation of Hand Hygiene Practices in Home Health Care.

Margaret V McDonald, Carlin Brickner, David Russell, Dawn Dowding, Elaine L Larson, Marygrace Trifilio, Irene Y Bick, Sridevi Sridharan, Jiyoun Song, Victoria Adams and 2 more

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
0.7field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.

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  4. Sticky apps, not sticky hands: A systematic review and content synthesis of hand hygiene mobile apps.Journal of the American Medical Informatics Association : JAMIA · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Margaret V McDonaldCenter for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA. Electronic address: margaret.mcdonald@vnsny.org.
Carlin BricknerCenter for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.
David RussellCenter for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA; Department of Sociology, Appalachian State University, Boone, NC, USA.
Dawn DowdingDivision of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester, UK.
Elaine L LarsonColumbia University School of Nursing, New York, NY, USA.
Marygrace TrifilioCenter for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.
Irene Y BickColumbia University School of Nursing, New York, NY, USA.
Sridevi SridharanCenter for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.
Jiyoun SongColumbia University School of Nursing, New York, NY, USA.
Victoria AdamsQuality Care Management, Visiting Nurse Service of New York, New York, NY, USA.
Kyungmi WooColumbia University School of Nursing, New York, NY, USA.
Jingjing ShangColumbia University School of Nursing, New York, NY, USA.
VNS Health · USColumbia University · USUniversity of Manchester · GB

Funding

Infection Control in Home Care and Predictive Risk ModelingR01HS024723 · AHRQ · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHANG, JINGJING · 2016 to 2018
$1.4M
AHRQ HHS R01 HS024723
6 · The paper itself

Abstract

objectiveTo describe nurse hand hygiene practices in the home health care (HHC) setting, nurse adherence to hand hygiene guidelines, and factors associated with hand hygiene opportunities during home care visits.

designObservational study of nurse hand hygiene practices.

settingand Participants: Licensed practical/vocational and registered nurses were observed in the homes of patients being served by a large nonprofit HHC agency.

methodsTwo researchers observed 400 home care visits conducted by 50 nurses. The World Health Organization's "5 Moments for Hand Hygiene" validated observation tool was used to record opportunities and actual practices of hand hygiene, with 3 additional opportunities specific to the HHC setting. Patient assessment data available in the agency electronic health record and a nurse demographic questionnaire were also collected to describe patients and nurse participants.

resultsA total of 2014 opportunities were observed. On arrival in the home was the most frequent opportunity (n = 384), the least frequent was after touching a patient's surroundings (n = 43). The average hand hygiene adherence rate was 45.6% after adjusting for clustering at the nurse level. Adherence was highest after contact with body fluid (65.1%) and lowest after touching a patient (29.5%). The number of hand hygiene opportunities was higher when patients being served were at increased risk of an infection-related emergency department visit or hospitalization and when the home environment was observed to be "dirty." No nurse or patient demographic characteristics were associated with the rate of nurse hand hygiene adherence. CONCLUSIONS AND IMPLICATIONS: Hand hygiene adherence in HHC is suboptimal, with rates mirroring those reported in hospital and outpatient settings. The connection between poor hand hygiene and infection transmission has been well studied, and it has received widespread attention with the outbreak of SARS-CoV-2. Agencies can use results found in this study to better inform quality improvement initiatives.

Indexed as

COVID-19Cross InfectionHand HygieneHome Care ServicesGuideline AdherenceHumansSARS-CoV-2hand hygienehome care serviceshome health nursingInfection control

Identifiers

PMID32943340
PMCPMC7490582
OpenAlexW3086697928

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.