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Eye-tracking to observe compliance with hand hygiene in the intensive care unit – a randomised feasibility study


Valek, Richard; Garcia, Pedro David Wendel; Schuepbach, Reto A; Buehler, Philipp K; Hofmaenner, Daniel A (2023). Eye-tracking to observe compliance with hand hygiene in the intensive care unit – a randomised feasibility study. Journal of Hospital Infection, 131:148-155.

Abstract

Background: Healthcare-associated infections are associated with increased patient mortality. Hand hygiene is the most effective method to reduce these infections. Despite simplification of this easy intervention, compliance with hand disinfection remains low. Current assessment of hand hygiene is mainly based on observation by hygiene specialists. The aim of this study was to investigate additional benefits of eye-tracking during the analysis of hand hygiene compliance of healthcare professionals in the intensive care unit.

Methods: In a simulated, randomised cross-over study conducted at the interdisciplinary intensive care unit of the University Hospital Zurich (Switzerland), doctors and nurses underwent eye-tracking and completed two everyday tasks (injection of 10 micrograms of norepinephrine via a central venous line, blood removal from the central line) in two scenarios where alcoholic dispenser locations differed ("in-sight" and "out-of-sight"). The primary outcomes were dwell time, revisits, first fixation duration and average fixation time on three areas of interest (central venous line, alcohol dispenser, protective glove box) for both scenarios. Compliance with hand hygiene guidelines was analysed.

Findings: 49 participants (35 nurses, 14 doctors) were included. Eye-tracking provided additional useful information compared to conventional observations. Dwell time, revisits, first fixation duration and average fixation time did not differ between the two scenarios for all areas of interest. Overall compliance with recommended hand hygiene measures was low in both doctors (mean 20%) and nurses (mean 42.9%).

Conclusion: Compared to conventional observations offered additional helpful insights and provided an in-depth analysis of gaze patterns during the recording of hand hygiene compliance in the intensive care unit.

Keywords: compliance; eye-tracking; hand hygiene; intensive care unit.

Abstract

Background: Healthcare-associated infections are associated with increased patient mortality. Hand hygiene is the most effective method to reduce these infections. Despite simplification of this easy intervention, compliance with hand disinfection remains low. Current assessment of hand hygiene is mainly based on observation by hygiene specialists. The aim of this study was to investigate additional benefits of eye-tracking during the analysis of hand hygiene compliance of healthcare professionals in the intensive care unit.

Methods: In a simulated, randomised cross-over study conducted at the interdisciplinary intensive care unit of the University Hospital Zurich (Switzerland), doctors and nurses underwent eye-tracking and completed two everyday tasks (injection of 10 micrograms of norepinephrine via a central venous line, blood removal from the central line) in two scenarios where alcoholic dispenser locations differed ("in-sight" and "out-of-sight"). The primary outcomes were dwell time, revisits, first fixation duration and average fixation time on three areas of interest (central venous line, alcohol dispenser, protective glove box) for both scenarios. Compliance with hand hygiene guidelines was analysed.

Findings: 49 participants (35 nurses, 14 doctors) were included. Eye-tracking provided additional useful information compared to conventional observations. Dwell time, revisits, first fixation duration and average fixation time did not differ between the two scenarios for all areas of interest. Overall compliance with recommended hand hygiene measures was low in both doctors (mean 20%) and nurses (mean 42.9%).

Conclusion: Compared to conventional observations offered additional helpful insights and provided an in-depth analysis of gaze patterns during the recording of hand hygiene compliance in the intensive care unit.

Keywords: compliance; eye-tracking; hand hygiene; intensive care unit.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Intensive Care Medicine
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Infectious Diseases, Microbiology (medical), General Medicine
Language:English
Date:1 January 2023
Deposited On:22 Nov 2022 08:55
Last Modified:28 May 2024 01:42
Publisher:Elsevier
ISSN:0195-6701
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.jhin.2022.09.025
PubMed ID:36243174
  • Content: Accepted Version
  • Language: English
  • Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)