Traditional Poster Round

Poster

Design and validation of an anatomical-based assessment scale for handwashing with hydro-alcoholic solution (HAS)

Tuesday, May 15
09:45 - 10:45
Location: The Gate, Atrium Level

Background: : Handwashing with hydro-alcoholic solution (HAS) is the gold standard of hand hygiene. Using an added fluorescent solution has been used to assess its quality. The published assessment scale used a division of each hand in 50 squares of identical size (“pixel” scale). However, handwashing is related to hand anatomy.

Research Question: : The aim of this study was to design and validate an anatomical-based assessment scale of the quality of handwashing with HAS.

Methodology: : The study took place in a Pediatric Department including medical and nursing providers.
Content of the scale (1 anatomist, 2 hygiene specialists, and 2 simulation experts) provided a division of hands into anatomical zones: 1 wrist, 3 for palm, 1 for each phalanx, and 4 interdigital ones only on the dorsal size.
Handwashing was performed using 7 steps, 20-30 sec method with HAS added with a fluorescent and tested under UV emission in a black box. Each side of both hands were photographed. Scoring was performed by 2 independent observers giving for each area: 0=dark, 1=mixed, or 2=white (clean). Total score was over 100.
Psychometric measurements were studied in 30 participants (120 hand sides).

Results: : The present scale was found valid (Cronbach alpha=0.829 dorsal side, 0.73 palmar side) and reproducible: no difference between observers (49.7±10.17 vs 49.1±10.23), and very strong correlation between their scores: R2=0.91, and intra-class coefficient=0.99. In comparison, the “pixel” scale was found not reliable: significant difference between observers, R2=0.33, ICC=0.31.

Discussion/Conclusions: : The anatomical scale presents a high internal coherence and is more reliable than the pixel scale. We found this tool useful to quantify the quality of handwashing with HAS. Further development should focus on creation of a software to analyze the score.





Julie Thomas

MD
Pediatric Department, University Hospital of Poitiers, France

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Elsa Delheis

MD
Pediatric Department, Hospital of Niort, France

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Daniel Aiham Ghazali

MD, PhD
Simulation Center, University of Paris-Diderot, Paris, France

Dr Daniel Aïham GHAZALI, MD, PhD
Emergency Department and EMS, University Hospital of Bochat, Paris, France
Simulation Center of Paris-Diderot University, Paris, France

Post Doctorate in SImulation
Reserach on teamwork and relationship between stress and performance

Teaching in the University of Poitiers (Pediatric Emergency) and in the University of Paris-Diderot (Emergency)

Publications in Education, Emergency, Critical care, and Pediatric journals

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Catherine Laland

MD
Hygiene Department, University Hospital of Poitiers, France

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Sarah Thevenot

MD
Hygiene Department, University Hospital of Poitiers, France

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Send Email for Jean Pierre Richer

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David Kessler, MD, MSc

Assistant Professor of Pediatrics
Columbia University College of Physicians and Surgeons
Leonia, NJ

David Kessler, MD, MSc, is a longtime student of the growing art & science of simulation. David’s experience with simulation-based medical education, standardized patients, patient outcome oriented research, quality improvement, and change management has resulted to numerous grant-funded studies and peer-reviewed publications. As the director of clinical simulation for the Pediatric Emergency Medicine Division at Columbia University Medical Center David has focused on leveraging inter-professional simulation (in situ) to grow the culture of safety, strengthen teamwork/communication, and improve patient care. As co-director and one of the co-founders for INSPIRE, (International Network for Simulation-based Pediatric Innovation, Research and Education) an international pediatric research network focused on outcome oriented simulation research in acute care, resuscitation and skills—David has helped to grow a community of practice dedicated to collaboration and mentorship among investigators committed to scholarship in simulation. Personal interests include using simulation to plan and assess new clinical spaces, and integrating innovative technology into healthcare.

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