04/13/23

To Assess the Effect of Camera To Assess the Effect of Camera Surveillance in Improving Surveillance in Improving

Compliance with Hand washing Compliance with Hand washing

Practices in the ICU SettingPractices in the ICU Setting

Shallu Chauhan, Deepak AgrawalShallu Chauhan, Deepak AgrawalDepartment of Neurosurgery, JPNATC, Department of Neurosurgery, JPNATC,

AIIMS, N DelhiAIIMS, N Delhi

04/13/23

BackgroundBackgroundHand 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

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AIMS & OBJECTIVESAIMS & OBJECTIVES

• To Asses the Effect To Asses the Effect of Camera of Camera Surveillance in Surveillance in Improving Improving Compliance with Compliance with Hand washing Hand washing Practices in the Practices in the ICU Setting.ICU Setting.

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MATERIALS AND MATERIALS AND METHODSMETHODS

• This was a prospective study carried out This was a prospective study carried out over one month period in one cubicle of over one month period in one cubicle of neurosurgery ICU.neurosurgery ICU.

• A surveillance camera which was A surveillance camera which was previously installed and functioning was previously installed and functioning was focused on a cubicle of three patients focused on a cubicle of three patients and recording of previous 24 hours was and recording of previous 24 hours was reviewed every day for 15 days.reviewed every day for 15 days.

• No of incidents in each shift duty were No of incidents in each shift duty were recordedrecorded

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INCIDENTINCIDENTAn incident was defined as An incident was defined as

any one of the following:any one of the following:• Hand washing not done by Hand washing not done by

health team workers.health team workers.

• Touching different patients Touching different patients without hand washing.without hand washing.

• Using the same gloves for Using the same gloves for different patients and for different patients and for different procedures.different procedures.

• Hand washing not done Hand washing not done after finishing the after finishing the procedures.procedures.

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MATERIALS AND MATERIALS AND METHODSMETHODS

• Following, this 15 day period, all staff Following, this 15 day period, all staff were verbally instructed in every shift were verbally instructed in every shift that they were under survellience for that they were under survellience for the next 15 days.the next 15 days.

• Camera recordings of previous 24 Camera recordings of previous 24 hours were similarly reviewed every hours were similarly reviewed every day for these 15 days and incidents day for these 15 days and incidents recorded..recorded..

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RESULTSRESULTS

First 15 days periodFirst 15 days period

• There were a total of 421 incidents There were a total of 421 incidents (n) when hand washing was not done.(n) when hand washing was not done.

• 84% (d=500) of the incidents 84% (d=500) of the incidents occurred in the night shift especially occurred in the night shift especially during the early morning hours. during the early morning hours.

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RESULTSRESULTS

Subsequent 15 days periodSubsequent 15 days period(when the staff were informed that they were under camera (when the staff were informed that they were under camera

surveillance)surveillance)

• The total number of events when The total number of events when hand washing was not done was 140.hand washing was not done was 140.

• Majority (90%) of the incidents Majority (90%) of the incidents occurred in the night shift.occurred in the night shift.

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RESULTSRESULTS

• The difference The difference between the between the two periods was two periods was statistically statistically highly highly significant significant (p=57%). (p=57%).

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STATISCAL ANALYSISSTATISCAL ANALYSISDATE AND DATE AND TIME TIME

NUMBER OF NUMBER OF EVENTS WHEN EVENTS WHEN IMPROPER IMPROPER HEALTH HEALTH PRACTISE HAS PRACTISE HAS DONE[n] DONE[n]

TOTAL TOTAL NUMBER OF NUMBER OF EVENTS WHEN EVENTS WHEN THE HEALTH THE HEALTH TEAM TEAM MEMBERS MEMBERS HANDLED THE HANDLED THE PATIENTS[d] PATIENTS[d]

TOTAL % OF TOTAL % OF IMPROPER IMPROPER HEALTH HEALTH PRACTISED PRACTISED HAS DONE IN HAS DONE IN THE I.C.U.[p] THE I.C.U.[p]

16/7/0916/7/09

4 a.m to 9 4 a.m to 9 a.ma.m

2626 3030 87%87%

17/7/0917/7/09

5a.m to 5a.m to 10a.m10a.m

2020 3232 63%63%

18/7/0918/7/09

6a.m to 6a.m to 11a.m11a.m

3030 3535 86%86%

19/7/0919/7/09

11a.m to 11a.m to 4p.m4p.m

2020 2525 80%80%

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20/7/0920/7/09

2p.m to 8p.m2p.m to 8p.m3434 4040 85%85%

21/7/0921/7/09

4p.m to 9p.m4p.m to 9p.m2424 2828 86%86%

22/7/0922/7/09

6a.m to 11a.m6a.m to 11a.m3636 4040 90%90%

23/7/0923/7/09

10a.m to 1p.m10a.m to 1p.m2929 3434 85%85%

24/7/0924/7/09

10p.m to 1a.m10p.m to 1a.m1414 2020 70%70%

25/07/0925/07/09

4p.m to 8p.m4p.m to 8p.m2222 2626 85%85%

26/7/0926/7/09

2p.m to 8p.m2p.m to 8p.m2424 3030 80%80%

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27/7/0927/7/09

11a.m to 5p.m11a.m to 5p.m2727 3333 81%81%

28/7/0928/7/09

6a.m to 11a.m6a.m to 11a.m3636 4040 90%90%

29/7/0929/7/09

5a.m to 1p.m5a.m to 1p.m3838 4242 90%90%

30/7/0930/7/09

5a.m to 1p.m5a.m to 1p.m4141 4545 91%91%

Staff is not aware of CCTVStaff is not aware of CCTV

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Post AwarenessPost AwarenessDATE DATE AND AND TIME TIME

NUMBER OF NUMBER OF EVENTS EVENTS WHEN WHEN IMPROPER IMPROPER HEALTH HEALTH PRACTISE PRACTISE HAS DONE HAS DONE

[n[n] ]

TOTAL TOTAL NUMBER OF NUMBER OF EVENTS WHEN EVENTS WHEN THE HEALTH THE HEALTH TEAM TEAM MEMBERS MEMBERS HANDLED THE HANDLED THE PATIENTS [d]PATIENTS [d]

TOTAL % OF TOTAL % OF IMPROPER IMPROPER HEALTH HEALTH PRACTISED HAS PRACTISED HAS DONE IN THE DONE IN THE

I.C.U.I.C.U.

1/08/091/08/09

5am to 5am to 11am11am

2020 4040 50%50%

2/08/092/08/09

4am to 4am to 2pm2pm

1818 4646 39%39%

3/08/093/08/09

6am to 6am to 11am11am

1414 3838 37%37%

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4/8/094/8/09

11a.m to 2p.m11a.m to 2p.m1010 3636 28%28%

5/8/095/8/09

3p.m to 10p.m3p.m to 10p.m66 2323 26%26%

6/8/096/8/09

11p.m to 6a.m11p.m to 6a.m88 4242 19%19%

7/8/097/8/09

5a.m to 10a.m5a.m to 10a.m1212 3434 31%31%

8/8/098/8/09

6a.m to 1p.m6a.m to 1p.m1010 3838 26%26%

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9/9/099/9/09

9a.m to 1pm9a.m to 1pm88 3434 23%23%

10/9/0910/9/09

3p.m to 7p.m3p.m to 7p.m66 3030 20%20%

11/9/0911/9/09

8p.m to 12m.n8p.m to 12m.n77 2828 25%25%

12/9/0912/9/09

4p.m to 8p.m4p.m to 8p.m55 2828 18%18%

13/9/0913/9/09

5a.m to 11a.m5a.m to 11a.m88 3838 21%21%

14/9/0914/9/09

11a.m to 4p.m11a.m to 4p.m44 3232 12%12%

17/9/0917/9/09

4p.m to 10p.m4p.m to 10p.m44 3636 11%11%

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CONCLUSIONSCONCLUSIONS Hand washing is Hand washing is

poorly practiced in poorly practiced in our I.C.U. set up by our I.C.U. set up by health personnel.health personnel.

As the maximum As the maximum number of incidents number of incidents occur in the night occur in the night shift, poor shift, poor motivation may be motivation may be one of the factors for one of the factors for this behavior.this behavior.

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Our study Our study shows that shows that

camera camera surveillance surveillance plays a major plays a major

role in role in changing the changing the staff behavior staff behavior

and may and may improve improve

compliance compliance with hand with hand washing.washing.

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THANKTHANK YOU YOU