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Article ; Online: Hand Hygiene Compliance in Nursing Homes - The Effects Of Feedback With Lights on Alcohol-based Hand Rub Dispensers.

Iversen, Anne-Mette / Hansen, Marco Bo / Kristensen, Brian / Ellermann-Eriksen, Svend

2024

Abstract: Background: Hand hygiene (HH) among healthcare workers (HCWs) is crucial in preventing infections in nursing homes. However, HH compliance (HHC) among HCWs remains low. This study aimed to investigate the effect of feedback lights on HCWs' HHC.: ... ...

Abstract	Background: Hand hygiene (HH) among healthcare workers (HCWs) is crucial in preventing infections in nursing homes. However, HH compliance (HHC) among HCWs remains low. This study aimed to investigate the effect of feedback lights on HCWs' HHC. Methods: A five-month interventional study was conducted in three wards in a nursing home in [blinded for reviewers]. During the intervention period, a green light with a smiley appeared on the alcohol-based hand rub (ABHR) dispensers when HCWs used the ABHR, acknowledging HCWs for using the ABHR. HHC was monitored using an automatic hand hygiene monitoring system (AHHMS). Results: A total of 64 HCWs were enrolled. The AHHMS collected 23,696 HH opportunities in apartments and dirty utility rooms. Overall, HHC in the apartments increased from 50% at baseline (95% CI: 48, 53) to 56% (95% CI: 54, 58) during the intervention. However, the increased HHC level was not sustained during follow-up. Conclusions: The AHHMS enabled assessment of the intervention. We found a significant effect of light-guided feedback in the apartments. However, the increased HHC was not sustained after the light was switched off.
Language	English
Publishing date	2024-04-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2024.03.018
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Article ; Online: Effects of data-driven feedback on nurses' and physicians' hand hygiene in hospitals - a non-resource-intensive intervention in real-life clinical practice.

Iversen, Anne-Mette / Hansen, Marco Bo / Ellermann-Eriksen, Svend

Infection prevention in practice

2023 Volume 5, Issue 4, Page(s) 100321

Abstract: Background: Hand hygiene (HH) by healthcare workers (HCWs) is one of the most important measures to prevent hospital-acquired infections. However, HCWs struggle to adhere to HH guidelines. We aimed to investigate the effect of a non-resource intensive ... ...

Abstract	Background: Hand hygiene (HH) by healthcare workers (HCWs) is one of the most important measures to prevent hospital-acquired infections. However, HCWs struggle to adhere to HH guidelines. We aimed to investigate the effect of a non-resource intensive intervention with group and individual feedback on HCWs HH in a real-life clinical practice during the COVID-19 pandemic. Methods: In 2021, an 11-month prospective, interventional study was conducted in two inpatient departments at a Danish university hospital. An automated hand hygiene monitoring system (Sani Nudge™) was used to collect data. HH opportunities and alcohol-based hand rub events were measured. Data were provided as HH compliance (HHC) rates. We compared HHC across 1) a baseline period, 2) an intervention period with weekly feedback in groups, followed by 3) an intervention period with weekly individual feedback on emails, and 4) a follow-up period. Results: We analyzed data from physicians ( Conclusions: The automated hand hygiene monitoring system enabled assessment of the interventions. We found no significant effect of group or individual feedback at the two departments. However, other factors may have influenced the results during the pandemic, such as time constraints, workplace culture, and the degree of leadership support.
Language	English
Publishing date	2023-10-31
Publishing country	England
Document type	Journal Article
ISSN	2590-0889
ISSN (online)	2590-0889
DOI	10.1016/j.infpip.2023.100321
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Article ; Online: Hand hygiene compliance in nursing home wards - the effect of increased accessibility of alcohol-based hand rub.

Iversen, Anne-Mette / Hansen, Marco Bo / Münster, Morten / Kristensen, Brian / Ellermann-Eriksen, Svend

The Journal of hospital infection

2024

Abstract: Background: Elderly nursing home (NH) residents are vulnerable to infections due to age, weakened immune system and comorbidities. Furthermore, microorganisms are easily transmitted in shared facilities. Hand hygiene (HH) is considered one of the most ... ...

Abstract	Background: Elderly nursing home (NH) residents are vulnerable to infections due to age, weakened immune system and comorbidities. Furthermore, microorganisms are easily transmitted in shared facilities. Hand hygiene (HH) is considered one of the most important measures to prevent transmission. We determined the effect of increased accessibility to alcohol-based hand rub (ABHR) in NH wards by monitoring HH compliance (HHC) among healthcare workers (HCWs). Methods: An 11-month intervention study was conducted in a Danish six-ward NH. Data were collected using an automatic hand hygiene monitoring system (AHHMS). After a baseline period, one extra ABHR dispenser was placed in each of the 150 apartments. We compared baseline HHC with the HHC during an immediate intervention period and a long-term intervention period. Results: We included 159 HCWs. The AHHMS registered 341,078 HH opportunities. Overall baseline HHC was 31% (95% CI: 30-32). A significant +18% absolute immediate effect (first five months) (95% CI: 17-19; p<0.0001) and +13 percentage points (95% CI: 11, 14; p<0.0001) long-term effect (another four months) were recorded. HCWs working day shifts and short-term employees had a higher baseline HHC than HCWs working evening/night shifts. However, HCWs working night shifts achieved the greatest long-term effect with a mean +27 percentage point difference (p<0.0001). Conclusions: Placing an additional ABHR dispenser strategically within staff workflow significantly increased HHC among HCWs, showcasing a noteworthy effect. The study is the first to report the effect on NH dispenser accessibility as a single intervention and demonstrate a significant unmet potential.
Language	English
Publishing date	2024-03-21
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2024.02.027
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Article ; Online: Effects of data-driven feedback on nurses' and physicians' hand hygiene in hospitals – a non-resource-intensive intervention in real-life clinical practice

Anne-Mette Iversen / Marco Bo Hansen / Svend Ellermann-Eriksen

Infection Prevention in Practice, Vol 5, Iss 4, Pp 100321- (2023)

2023

Abstract: Summary: Background: Hand hygiene (HH) by healthcare workers (HCWs) is one of the most important measures to prevent hospital-acquired infections. However, HCWs struggle to adhere to HH guidelines. We aimed to investigate the effect of a non-resource ... ...

Abstract	Summary: Background: Hand hygiene (HH) by healthcare workers (HCWs) is one of the most important measures to prevent hospital-acquired infections. However, HCWs struggle to adhere to HH guidelines. We aimed to investigate the effect of a non-resource intensive intervention with group and individual feedback on HCWs HH in a real-life clinical practice during the COVID-19 pandemic. Methods: In 2021, an 11-month prospective, interventional study was conducted in two inpatient departments at a Danish university hospital. An automated hand hygiene monitoring system (Sani Nudge™) was used to collect data. HH opportunities and alcohol-based hand rub events were measured. Data were provided as HH compliance (HHC) rates. We compared HHC across 1) a baseline period, 2) an intervention period with weekly feedback in groups, followed by 3) an intervention period with weekly individual feedback on emails, and 4) a follow-up period. Results: We analyzed data from physicians (N=65) and nurses (N=109). In total, 231,022 hygiene opportunities were analyzed. Overall, we observed no significant effect of feedback, regardless of whether it was provided to the group or individuals. We found a trend toward a higher HHC in staff restrooms than in medication rooms and patient rooms. The lowest HHC was found in patient rooms. Conclusions: The automated hand hygiene monitoring system enabled assessment of the interventions. We found no significant effect of group or individual feedback at the two departments. However, other factors may have influenced the results during the pandemic, such as time constraints, workplace culture, and the degree of leadership support.
Keywords	Individual feedback ; Group feedback ; Hospital-acquired infection ; Infection prevention ; Electronic monitoring systems ; Nudging ; Infectious and parasitic diseases ; RC109-216 ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effects of light-guided nudges on health care workers' hand hygiene behavior.

Iversen, Anne-Mette / Hansen, Marco Bo / Alsner, Jan / Kristensen, Brian / Ellermann-Eriksen, Svend

American journal of infection control

2023 Volume 51, Issue 12, Page(s) 1370–1376

Abstract: Background: Hospital-acquired infections are the most frequent adverse events in health care and can be reduced by improving the hand hygiene compliance (HHC) of health care workers (HCWs). We aimed to investigate the effect of nudging with sensor ... ...

Abstract	Background: Hospital-acquired infections are the most frequent adverse events in health care and can be reduced by improving the hand hygiene compliance (HHC) of health care workers (HCWs). We aimed to investigate the effect of nudging with sensor lights on HCWs' HHC. Methods: An 11-month intervention study was conducted in 2 inpatient departments at a university hospital. An automated monitoring system (Sani Nudge Results: A total of 91 physicians, 135 nurses, and 15 cleaning staff were enrolled in the study. The system registered 274,085 hand hygiene opportunities in patient rooms, staff restrooms, clean rooms, and unclean rooms. Overall, a significant, sustained effect was achieved by nudging with lights in relation to contact with patients and patient-near surroundings for both nurses and physicians. Furthermore, a significant effect was observed on nurses' HHC in restrooms and clean rooms. No significant effect was found for the cleaning staff. Conclusions: Reminder or feedback nudges with light improved and sustained physicians' and nurses' HHC, and constitute a new way of changing HCWs' hand hygiene behavior.
MeSH term(s)	Humans ; Hand Hygiene ; Guideline Adherence ; Health Personnel ; Cross Infection/prevention & control ; Hospitals, University ; Hand Disinfection
Language	English
Publishing date	2023-05-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2023.05.006
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Zs.A 1773: Show issues

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Article ; Online: Clinical evaluation of an electronic hand hygiene monitoring system.

Iversen, Anne-Mette / Hansen, Marco Bo / Kristensen, Brian / Ellermann-Eriksen, Svend

American journal of infection control

2022 Volume 51, Issue 4, Page(s) 376–379

Abstract: Background: We aimed to test the accuracy of an electronic hand hygiene monitoring system (EHHMS) during daily clinical activities in different wards and with varying health care professions.: Methods: The accuracy of an EHHMS (Sani Nudge) was ... ...

Abstract	Background: We aimed to test the accuracy of an electronic hand hygiene monitoring system (EHHMS) during daily clinical activities in different wards and with varying health care professions. Methods: The accuracy of an EHHMS (Sani Nudge) was assessed during real clinical conditions by comparing events registered by two observers in parallel with events registered by the EHHMS. The events were categorized as true-positive, false-positive, and false-negative registrations. Sensitivity and positive predictive value (PPV) were calculated. Results: A total of 103 events performed by 25 health care workers (9 doctors, 11 nurses, and 5 cleaning assistants) were included in the analyses. The EHHMS had a sensitivity of 100% and a PPV of 100% when measuring alcohol-based hand rub. When looking at the hand hygiene opportunities of all health care workers combined taking place in the patient rooms and working rooms, the sensitivity was 75% and the PPV 95%. For doctors' and nurses' taking care of patients in their beds the EHHMS had a sensitivity of 100% and a PPV of 94%. Conclusions: The objective accuracy measures demonstrate that this EHHMS can capture hand hygiene behavior under clinical conditions in different settings with clinical health care workers but show less accuracy with cleaning assistants.
MeSH term(s)	Humans ; Hand Hygiene ; Infection Control ; Health Personnel ; Hospitals ; Electronics ; Guideline Adherence ; Cross Infection/prevention & control ; Hand Disinfection
Language	English
Publishing date	2022-06-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2022.06.017
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Article ; Online: Postoperative bleeding and venous thromboembolism in colorectal cancer patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: a systematic review and meta-analysis.

Lundbech, Mikkel / Krag, Andreas Engel / Iversen, Lene Hjerrild / Hvas, Anne-Mette

International journal of colorectal disease

2021 Volume 37, Issue 1, Page(s) 17–33

Abstract: Purpose: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival for selected patients with peritoneal metastases from colorectal cancer. Previous studies report conflicting rates of postoperative ... ...

Abstract	Purpose: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival for selected patients with peritoneal metastases from colorectal cancer. Previous studies report conflicting rates of postoperative bleeding and venous thromboembolism (VTE) after CRS + HIPEC. The aim of the present study was to systematically review the literature and to estimate the overall 30-day incidence of postoperative bleeding and the overall 90-day incidence of VTE after CRS + HIPEC. Methods: Studies were identified in PubMed, Embase, and Web of Science on 29 April 2021. Data were extracted for a qualitative synthesis and to estimate an overall mean incidence in the meta-analysis. Results: Fourteen studies with a total of 3268 patients were included in the systematic review. Postoperative bleeding incidence rates within 30 days ranged from 1.7 to 8.3% with an overall 30-day postoperative bleeding incidence with [95% CI] at 4.2 [2.6;6.2]%. VTE incidence rates within 90 days ranged from 0.2 to 13.6% with an overall 90-day VTE incidence with [95% CI] at 2.7 [1;5.2]% after CRS + HIPEC. Conclusion: This systematic review and meta-analysis indicate a low risk for postoperative bleeding within 30 days and VTE within 90 days after CRS + HIPEC for peritoneal metastases from colorectal cancer.
MeSH term(s)	Colorectal Neoplasms/drug therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/adverse effects ; Humans ; Hyperthermia, Induced/adverse effects ; Peritoneal Neoplasms/therapy ; Prognosis ; Retrospective Studies ; Survival Rate ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology
Language	English
Publishing date	2021-10-09
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-021-04021-6
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Article ; Online: Analysis of social interactions and risk factors relevant to the spread of infectious diseases at hospitals and nursing homes.

Frederik Boe Hüttel / Anne-Mette Iversen / Marco Bo Hansen / Bjarne Kjær Ersbøll / Svend Ellermann-Eriksen / Niels Lundtorp Olsen

PLoS ONE, Vol 16, Iss 9, p e

2021 Volume 0257684

Abstract: Ensuring the safety of healthcare workers is vital to overcome the ongoing COVID-19 pandemic. We here present an analysis of the social interactions between the healthcare workers at hospitals and nursing homes. Using data from an automated hand hygiene ... ...

Abstract	Ensuring the safety of healthcare workers is vital to overcome the ongoing COVID-19 pandemic. We here present an analysis of the social interactions between the healthcare workers at hospitals and nursing homes. Using data from an automated hand hygiene system, we inferred social interactions between healthcare workers to identify transmission paths of infection in hospitals and nursing homes. A majority of social interactions occurred in medication rooms and kitchens emphasising that health-care workers should be especially aware of following the infection prevention guidelines in these places. Using epidemiology simulations of disease at the locations, we found no need to quarantine all healthcare workers at work with a contagious colleague. Only 14.1% and 24.2% of the health-care workers in the hospitals and nursing homes are potentially infected when we disregard hand sanitization and assume the disease is very infectious. Based on our simulations, we observe a 41% and 26% reduction in the number of infected healthcare workers at the hospital and nursing home, when we assume that hand sanitization reduces the spread by 20% from people to people and 99% from people to objects. The analysis and results presented here forms a basis for future research to explore the potential of a fully automated contact tracing systems.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Analysis of social interactions and risk factors relevant to the spread of infectious diseases at hospitals and nursing homes.

Hüttel, Frederik Boe / Iversen, Anne-Mette / Bo Hansen, Marco / Kjær Ersbøll, Bjarne / Ellermann-Eriksen, Svend / Lundtorp Olsen, Niels

PloS one

2021 Volume 16, Issue 9, Page(s) e0257684

Abstract	Ensuring the safety of healthcare workers is vital to overcome the ongoing COVID-19 pandemic. We here present an analysis of the social interactions between the healthcare workers at hospitals and nursing homes. Using data from an automated hand hygiene system, we inferred social interactions between healthcare workers to identify transmission paths of infection in hospitals and nursing homes. A majority of social interactions occurred in medication rooms and kitchens emphasising that health-care workers should be especially aware of following the infection prevention guidelines in these places. Using epidemiology simulations of disease at the locations, we found no need to quarantine all healthcare workers at work with a contagious colleague. Only 14.1% and 24.2% of the health-care workers in the hospitals and nursing homes are potentially infected when we disregard hand sanitization and assume the disease is very infectious. Based on our simulations, we observe a 41% and 26% reduction in the number of infected healthcare workers at the hospital and nursing home, when we assume that hand sanitization reduces the spread by 20% from people to people and 99% from people to objects. The analysis and results presented here forms a basis for future research to explore the potential of a fully automated contact tracing systems.
MeSH term(s)	Communicable Diseases/epidemiology ; Communicable Diseases/transmission ; Computer Simulation ; Denmark/epidemiology ; Health Personnel ; Hospitals ; Humans ; Nursing Homes ; Risk Factors ; Social Interaction
Language	English
Publishing date	2021-09-20
Publishing country	United States
Document type	Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0257684
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Fusion Clinic: Integrating the care of people with severe mental illness and diabetes.

Rønne, Sabrina Trappaud / Hansen, Anne B / Zabell, Vicki / Santos, Monica / Olsen, Mette Wallbohm / Iversen, Peter Bindslev / Tarnow, Lise / Holt, Richard I G

Diabetic medicine : a journal of the British Diabetic Association

2023 Volume 41, Issue 5, Page(s) e15255

Abstract: Aim: People with coexisting severe mental illness (SMI) and type 2 diabetes have a shorter life expectancy and poorer diabetes outcomes than those without SMI. This is partly explained by the separate treatment of diabetes and SMI, which occurs in ... ...

Abstract	Aim: People with coexisting severe mental illness (SMI) and type 2 diabetes have a shorter life expectancy and poorer diabetes outcomes than those without SMI. This is partly explained by the separate treatment of diabetes and SMI, which occurs in parallel silos in many healthcare systems. The Steno Diabetes Center Sjaelland and Region Zealand established the Fusion Clinic to offer combined psychiatric and diabetes care delivered by both diabetes and mental healthcare professionals. This study describes how the clinic was established and the initial diabetes outcomes. Methods: The Fusion Clinic was co-designed by people with diabetes and SMI and healthcare professionals to improve the care of adults with diabetes and SMI. The clinic approach utilised the F-ACT model. The 63 people referred to the Fusion Clinic between 01.02.2020 and 01.01.2022 who attended the clinic for more than 6 months were included in this study. Diabetes outcomes were recorded in the electronic medical records (Sundhedsplatformen EPIC). Results: There was a high prevalence of diabetes complications at baseline. Furthermore, 70% had one or more additional concomitant diseases, as well as SMI and diabetes. Assessment of diabetes complications and measurements of HbA Conclusions: This model of service delivery has the potential to improve the quality of care for people with SMI and type 2 diabetes.
MeSH term(s)	Adult ; Humans ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Mental Disorders/epidemiology ; Mental Disorders/therapy ; Mental Disorders/psychology ; Delivery of Health Care ; Ambulatory Care Facilities ; Diabetes Complications/epidemiology ; Diabetes Complications/therapy ; Diabetes Complications/complications
Language	English
Publishing date	2023-11-15
Publishing country	England
Document type	Journal Article
ZDB-ID	605769-x
ISSN	1464-5491 ; 0742-3071 ; 1466-5468
ISSN (online)	1464-5491
ISSN	0742-3071 ; 1466-5468
DOI	10.1111/dme.15255
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