Evidence map›Paper›PMID 33361245›Full record

ArticleGlobal health, science and practice2020

A Practical Guide to Using Time-and-Motion Methods to Monitor Compliance With Hand Hygiene Guidelines: Experience From Tanzanian Labor Wards.

Giorgia Gon, Said M Ali, Robert Aunger, Oona M Campbell, Mícheál de Barra, Marijn de Bruin, Mohammed Juma, Stephen Nash, Amour Tajo, Johanna Westbrook and 2 more

Abstract read
In one paragraph

Article in Global health, science and practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
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.

Giorgia GonLondon School of Hygiene and Tropical Medicine, London, United Kingdom. Giorgia.gon@lshtm.ac.uk.
Said M AliPublic Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania.
Robert AungerLondon School of Hygiene and Tropical Medicine, London, United Kingdom.
Oona M CampbellLondon School of Hygiene and Tropical Medicine, London, United Kingdom.
Mícheál de BarraBrunel University London, Department of Life Sciences, Uxbridge, United Kingdom.
Marijn de BruinInstitute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.
Mohammed JumaPublic Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania.
Stephen NashLondon School of Hygiene and Tropical Medicine, London, United Kingdom.
Amour TajoPublic Health Laboratory-Ivo de Carneri, Pemba, Zanzibar, Tanzania.
Johanna WestbrookMacquarie University, Sydney, Australia.
Susannah WooddLondon School of Hygiene and Tropical Medicine, London, United Kingdom.
Wendy J GrahamLondon School of Hygiene and Tropical Medicine, London, United Kingdom.

Funding

Medical Research Council MR/N015975/1
6 · The paper itself

Abstract

backgroundGood-quality evidence on hand hygiene compliance among birth attendants in low-resource labor wards is limited. The World Health Organization Hand Hygiene Observation Form is widely used for directly observing behaviors, but it does not support capturing complex patterns of behavior. We developed the HANDS at Birth tool for direct observational studies of complex patterns of hand rubbing/washing, glove use, recontamination, and their determinants among birth attendants. Understanding these behaviors is particularly critical in wards with variable patient volumes or unpredictable patient complications, such as emergency departments, operating wards, or triage and isolation wards during epidemics. Here we provide detailed information on the design and implementation of the HANDS at Birth tool, with a particular focus on low-resource settings. We developed the HANDS at Birth tool from available guidelines, unstructured observation, and iterative refinement based on consultation with collaborators and pilot results. We designed the tool with WOMBAT software, which supports collecting multidimensional time-and-motion data. Our analysis of the tool's performance centered on interobserver agreement and convergent validity and the implications of the data structure for data analysis. The HANDS at Birth tool encompasses various hand actions and context-relevant information. Hand actions include procedures relevant during labor and delivery; hand hygiene or glove actions; and other types of touch. During field implementation, we used the tool for continuous observation of the birth attendant. Interobserver agreement was good (kappa range: 0.7-0.9), and the tool showed convergent validity. Using the HANDS at Birth tool is a feasible way to obtain useful information about compliance with hand hygiene procedures. The tool could be used after simple training and allows for collection of reliable information about the complex pattern of hygiene behaviors. Future studies should explore using this tool to observe behavior in labor wards in other settings and in other types of wards.

Indexed as

Cross InfectionHand HygieneLabor, ObstetricFemaleGuideline AdherenceHand DisinfectionHospitalsHumansInfant, NewbornPregnancy

Identifiers

PMID33361245
PMCPMC7784080

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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.