Does Observation Improve Compliance to Standard Surgical Hand Scrubbing?
DOI:
https://doi.org/10.52206/jsmc.2024.14.4.933Keywords:
Compliance, Covert observation, Hand hygiene, Hawthorne effect, Overt observation, Surgical site infection.Abstract
Background: Standard surgical hand scrubbing techniques are essential for the prevention of surgical site infections. Overt observation is the gold standard to assess compliance to surgical hand scrubbing techniques but is confounded by the Hawthorne effect.
Objective: To compare the compliance of surgical hand scrubbing technique in Orthopaedic operation theatres as observed overtly and covertly by trained independent observers.
Materials and Methods: We conducted this cross sectional study in Orthopaedic operation theatres of Lady Reading Hospital, Peshawar, from 15th November 2023 to 15th February 2024. All the participants fulfilling inclusion criteria were overtly and covertly observed by independent trained observers for compliance to WHO surgical hand scrubbing techniques. The difference in the rate of surgical hand scrubbing compliance between overt and covert observations served as a measure of the Hawthorne effect.
Results: The total number of participants in our study were 48 including 11 Orthopaedic consultants and 37 Orthopaedic residents. The overt observation revealed that the compliance to the various steps of WHO surgical hand scrubbing ranges from 89.58% to 100% with a weighted mean of 95.76%. The compliance rate ranged from 60.41% to 89.58% with a weighted mean of 68.43% when data was collected through covert observation. The overall increased compliance rate reported through covert observation as compared to overt observation(P=0.007) is attributed to the Hawthorne effect.
Conclusion: Compliance of the Orthopaedic consultants and residents to the standard surgical hand scrubbing technique in Orthopaedic operation theatre was significantly high with overt observation than with covert observation.
Keywords: Compliance, Covert observation, Hand hygiene, Hawthorne effect, Overt observation, Surgical site infection.
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