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Lilian AllenFollow

Abstract

Abstract

Objective: This is a quality improvement project aimed to evaluate the effectiveness of an educational training initiative on hand-hygiene (HH) for health care providers in women's health department to identify learning needs, behaviors, and attitudes.

Design: A descriptive, prospective, longitudinal design, using baseline data collection points before the web-based intervention was introduced (time 0), immediately after the web-based intervention completion (time 1), one to six weeks after completion of the intervention (time 2).

Setting: A Chicagoland area tertiary care hospital.

Participants: Clinical staff of the women's care center, which included the Labor and Delivery, Mother and Baby, and Obstetrics Emergency Room OB ER units.

Intervention: One-hour web-based educational training initiative on HH.

Primary Outcome Measure(s): HH knowledge and reduction of the rate of postpartum surgical site infection. Response to questions on knowledge of hand hygiene was compared between pre-intervention and post-intervention periods using McNemar's test. Attitude and behavior towards hand hygiene were measured using a scale comprising of a battery of eight items measured on a Likert agreement scale from 1 (strongly disagree) to 5 (strongly agree).

Results: Changes in attitude and behavior towards hand hygiene across three measurements were tested using repeated measures ANOVA test for each question on attitude and behavior and then for the overall aggregate. The analysis showed that there is no significant difference between the postintervention (time 2) and one to six weeks after intervention (time 3) with F test statistics =.230; p= >0.05. The postintervention data showed 124 CS cases with one SSI (0.82%) when compared to preintervention data that showed 126 cases with four SSI reported (3.2%)

Conclusions: To maximize compliance and to improve the knowledge and skills of the clinical staff on infection control and prevention measures, the leadership must provide support to staff and enforce training and skills development. This QIP is a single modality approach which could be more beneficial if it is combined with other influencers reported in the literature such as performance feedback, frequent reminder, compliance observations, surveillance, monitoring, and auditing shares should also be incorporated in practice guidelines or policies and procedures. Quality improvement projects related to infection control within the healthcare organization should be a mandatory process for all staff to reduce the financial burden to the institution, insurer, and society.

Keywords: Postpartum surgical site infection, Quality improvement project, Hand hygiene,

Patient safety, Women's Care Department.

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Examining the Efficacy of Web-Based Quality Improvement Hand Hygiene Education in Reducing Post-Cesarean Birth Surgical Site Infection

Abstract

Objective: This is a quality improvement project aimed to evaluate the effectiveness of an educational training initiative on hand-hygiene (HH) for health care providers in women's health department to identify learning needs, behaviors, and attitudes.

Design: A descriptive, prospective, longitudinal design, using baseline data collection points before the web-based intervention was introduced (time 0), immediately after the web-based intervention completion (time 1), one to six weeks after completion of the intervention (time 2).

Setting: A Chicagoland area tertiary care hospital.

Participants: Clinical staff of the women's care center, which included the Labor and Delivery, Mother and Baby, and Obstetrics Emergency Room OB ER units.

Intervention: One-hour web-based educational training initiative on HH.

Primary Outcome Measure(s): HH knowledge and reduction of the rate of postpartum surgical site infection. Response to questions on knowledge of hand hygiene was compared between pre-intervention and post-intervention periods using McNemar's test. Attitude and behavior towards hand hygiene were measured using a scale comprising of a battery of eight items measured on a Likert agreement scale from 1 (strongly disagree) to 5 (strongly agree).

Results: Changes in attitude and behavior towards hand hygiene across three measurements were tested using repeated measures ANOVA test for each question on attitude and behavior and then for the overall aggregate. The analysis showed that there is no significant difference between the postintervention (time 2) and one to six weeks after intervention (time 3) with F test statistics =.230; p= >0.05. The postintervention data showed 124 CS cases with one SSI (0.82%) when compared to preintervention data that showed 126 cases with four SSI reported (3.2%)

Conclusions: To maximize compliance and to improve the knowledge and skills of the clinical staff on infection control and prevention measures, the leadership must provide support to staff and enforce training and skills development. This QIP is a single modality approach which could be more beneficial if it is combined with other influencers reported in the literature such as performance feedback, frequent reminder, compliance observations, surveillance, monitoring, and auditing shares should also be incorporated in practice guidelines or policies and procedures. Quality improvement projects related to infection control within the healthcare organization should be a mandatory process for all staff to reduce the financial burden to the institution, insurer, and society.

Keywords: Postpartum surgical site infection, Quality improvement project, Hand hygiene,

Patient safety, Women's Care Department.