Browsing by Author "Moore, Lori"

Now showing 1 - 3 of 3

Drastic hourly changes in hand hygiene workload and performance rates: a multicenter time series analysis
(Elsevier BV, 2024-09) Moore, Lori; Arbogast, James W.; Robbins, Greg; DiGiorgio, Megan; Parker, Albert E.
Background. High hand hygiene (HH) workload is a commonly cited barrier to optimal HH performance. The objective of this study was to assess trends of HH workload as defined by HH opportunities (HHO) and performance rates over different timescales using automated HH monitoring system data. Methods. This multiyear retrospective observational study was conducted in 58 inpatient units located in 10 North American hospitals. HHO and HH rates were analyzed by time series mixed effects general additive model. Results. Median HH rates peaked at 50.0 between 6 and 7 AM with a trough of 38.2 at 5 PM. HHO over hours in a day were the highest at 184 per hospital unit per hour at 10 AM with a trough of 49.0 between 2 and 3 AM. Median rates for day and night shifts were 40.8 and 45.5, respectively (P = .078). Weekend day shift had the lowest median rate (39.4) compared with any other 12-hour shift (P < .1018). The median rates and HHO varied little across days in a week and months. Conclusions. HH workload and performance rates were negatively correlated and changed drastically over hours in a day. Hospitals should consider HH workload in the development and timely delivery of improvement interventions.
Who goes in and out of patient rooms? An observational study of room entries and exits in the acute care setting
(2019-05) Arbogast, James W.; Moore, Lori; Clark, Tracy; Thompson, Maria
The objective of this study is to determine what percentage of patient room entries and exits (opportunities) are attributed to health care personnel (HCP) and non-HCP. A total of 14,876 opportunities were observed by clinicians in 29 units of 16 hospitals. HCP accounted for 83.6%; 95% confidence interval, 81.3%-87.6%. This finding provides hospitals an initial baseline for HCP room traffic when implementing community-based automated hand hygiene monitoring and compliance improvement efforts.
Who Goes in and Out of the Hospital Patient Room?
(2017-06) Arbogast, James W.; Quinn, Jeff; Clark, Tracy; Moore, Lori; Thompson, Maria; Wagner, Pamela; Young, Elizabeth; Parker, Albert E.
BACKGROUND: The objective of this study was to determine what percentage of entries and exits (E/E) in and out of the patient room should be attributed to healthcare workers (HCWs) in a wide variety of hospital units. This is a critical question for hospitals considering an automated monitoring system (AMS) to measure hand hygiene performance (HHP) as a complement to data from visual observation. HCWs often implicate others and do not perceive a need to change their HH behavior because they are convinced that visitors, patients, and others are responsible for very low HHP data. METHODS: Events (defined as patient room E/E) were observed and recorded by nurses not employed by the hospital. Observations were made in US and Canadian hospital units including emergency, ICU, medical surgical, oncology, and pediatrics. Observers classified events by: HCWs (e.g., nursing staff, aides, doctors, EVS, etc.), patients plus visitors, and other (e.g., clergy, hospice workers). Logistic regression was used to determine who was responsible for the most E/E events by category of individuals. RESULTS: Observers recorded a total of 14,876 E/E events in 29 units of 16 hospitals with units varying in size from 10 to 41 beds. 84.3% of all E/E were attributed to HCWs; 15.0% were from patients plus visitors and 0.7% from others. The odds are 6 to 1 that an E/E into a patient room is by a HCW (P < .0005). Pediatric units had the lowest percentage of HCWs E/E (76.7% total) CONCLUSIONS: This study demonstrates HCWs account for the greatest proportion of hospitalized patient room E/E. Further, the data show that others share a very small percentage of room E/E countering the argument that those individuals are responsible for the low unit HHP measured by AMS. This study demonstrates that other categories of individuals are not a deterrent to increasing unit-level HHP.