Effect of video camera monitoring feedback on hand hygiene compliance in neonatal intensive care unit, an interventional study

Background: The purpose of this study was to determine whether use of a video camera surveillance system for hand hygiene (HH) monitoring, video-based education, and feedback could improve the HH compliance in a neonatal intensive care unit (NICU). Methods and materials: This was an interventional before-after trial conducted in a level-III NICU between July 2019 and June 2020. HH compliance was measured using randomly selected video-camera footage in the baseline, intervention, and maintenance periods. After the baseline, an intervention consisting of feed-back and education with video scenarios was implemented. The primary outcome was change in HH compli-ance. The compliance rates were analyzed as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study period. Results: We identified a total of 8335 HH indications. There were non significant increases in the total com-pliance rate (9.0%, 95% CI-2% to 20%) at the time of intervention andin the compliance rate after intervention (0.26%, 95% CI-0.31% to 0.84%) per day. The hand hygiene compliance before patient contact significantly increased (19.8%, 95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention (-3.4%, 95% CI-13.4% to 6.7%). Conclusion: In this study of HH monitoring using video-camera footage combined with an intervention including feedback and education, there were inconsistent improvements in HH compliance. However, these