ICAP

Hand hygiene is a core approach to reducing health care-associated infections and ensuring patient safety during medical care. In Ukraine, however, the Ukrainian Public Health Center (UPHC) found that 44.3 percent of health care workers lack effective hand rubbing skills.

ICAP at Columbia University has developed an electronic tool to monitor hand hygiene compliance among health care workers in Ukraine to strengthen hand hygiene programs and ultimately establish and improve infection prevention and control (IPC) standards.

The tool has been successfully piloted in four hospitals in Ukraine over a two-month period beginning in October 2024. Hand hygiene monitoring is conducted using World Health Organization (WHO)-recommended methodologies, which have been adapted and translated into Ukrainian.

Three women in uniforms stand in a room with light-colored walls and a glass-panel door. One woman is holding and pointing at a tablet, while the other two look on attentively. They appear to be engaged in a discussion.

Khmelnytskyi City Hospital

Traditionally, data collection on hand hygiene relied on paper forms – a time-consuming process involving the manual calculation of approximately ten variables. The new tool measures, for example, types of hand hygiene performed in the clinical setting – such as handwashing with soap and water or rubbing antiseptic – and how many times health care workers perform these actions. The data can be stratified by units, time periods, and cadre of health care workers, and the application can be installed on a tablet, making the monitoring process more efficient and user-friendly. All calculations are performed automatically, with results accessible on both the tablet and on the hand hygiene coordinator’s laptop.

“Visiting hospital units and monitoring hand hygiene using a tablet with the app installed makes the monitoring process more convenient and speeds up the calculations,” said Rosaliya Sanitska, hand hygiene coordinator at Utility Enterprise Khmelnytskyi City Hospital. “A modern approach using digital technologies in the work of the infection control department increases the level of respect and trust from health care workers.”

With the electronic tool, hand hygiene coordinators at the four participating hospitals can immediately demonstrate monitoring results to both unit heads and clinician teams. Dashboards for data visualization allow the ICAP in Ukraine team and hand hygiene specialists of the UPHC to monitor the dynamics of hand hygiene compliance trends and offer targeted support.

A healthcare worker tends to a patient on a hospital bed while another person takes notes on a tablet. An IV stand is nearby, and light streams in through a window with lace curtains.

Following the pilot period, the monitoring tool continues to be implemented while being refined for optimal performance.

“One of the biggest challenges was the lack of understanding among staff of the importance of using the hand hygiene monitoring tool as well as the low level of computer literacy,” Anastasiia Zhabko, a strategic information and epidemiology specialist at ICAP in Ukraine. “This required additional training and communication efforts. To overcome this problem, we held several training sessions for staff, highlighting the benefits of using the tool, and provided ongoing technical support throughout the pilot.”

Over the piloting period, participating hospitals made significant progress by implementing regular hand hygiene monitoring for the first time; each hospital now has its own hand hygiene improvement plan that will be tracked over time for effectiveness. Importantly, implementing the hand hygiene monitoring tool is an essential component of ICAP in Ukraine’s major overarching goals.

“ICAP’s goal in Ukraine is to prevent the spread of antimicrobial resistance, among other aims, through the implementation of IPC measures,” said Mariia Panasiuk, ICAP in Ukraine’s clinical specialist. “Improving hand hygiene is one of the mandatory components of IPC. It could even be considered the most important component, as according to the World Health Organization, the introduction of hand hygiene in hospitals alone can reduce the spread of hospital-associated infections by up to 50 percent. At a time when hospitals may be overwhelmed by the injured, it is especially important to maintain good hand hygiene to prevent infection in the hospital and to combat the spread of antimicrobial resistance.”

About ICAP

A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu

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