Authors (including presenting author) :
Kwok WC(1), Chow WL(1), Leung WN(2)
Affiliation :
(1)Department of Radiology, NTWC, (2)Infection Control Team, Tuen Mun Hospital
Introduction :
Hand hygiene compliance rate among radiographers during mobile X-ray service in wards is lower than that of other allied health professionals in TMH (NTWC ICN, 2024). Despite its importance in preventing cross-contamination, radiographers encountered difficulties in complying with ‘Five-Moments for Hand Hygiene’ in real situation, resulting in low compliance rate.
Objectives :
1.Identify commonly missed steps in ‘Five-Moments of Hand Hygiene’ during mobile X-ray service. 2.Propose practical workflow / modified hand hygiene workflow to address these challenges.
Methodology :
1.Recognize the missed-moments of hand hygiene during mobile X-ray service. 2.Based on hand hygiene audit report, radiographers often missed performing hand hygiene after positioning patient then touching mobile X-ray machine (Moments-4 and -5). Similarly, hand hygiene before re-contacting patient during re-positioning (Moment-1) is missed. 3.Worked with ICN, a Modified-Workflow, was designed based on the situation. It involved cleaning X-ray machine with alcohol-wipes after each use, treating it as a "single-use" item. This eliminated risks associated with ‘Missed-Moments’. 4.A guideline, “新界西放射科流動X光機清潔步驟” , was created to train supporting staff who were responsible for machine cleaning. 5.To assess feasibility, the throughput before and after implementation was compared. Also, a questionnaire was distributed to radiographers to evaluate the satisfaction of the Modified-Workflow.
Result & Outcome :
Pilot run in TSWH-DR began on 17 Oct 2024 without major issues. Full implementation at NTWC-DR began on 21 Nov 2024, with no reported problems. To address the usefulness of the Modified-Workflow: 1). comparison of caseload before and after Modified-Workflow; 2). questionnaire for radiographers’ opinions on Modified-Workflow. Random one-week caseload in TMH-DR showed: • before implementation : 1117 • after implementation : 1222 A two-sample t-test revealed no statistically significant difference in throughput. Questionnaire was distributed to 24 radiographers who performed mobile X-ray service after implementation of Modified-Workflow. 14 replies collected. All replies acknowledged the hand hygiene workflow was modified, but only ~80% replies showed they knew the reason for modifying the workflow and ~72% replied indicated Modified-Workflow was preferred rather than the original 5-moments technique. Conclusion: In terms of caseload, the modified hand hygiene workflow can enhance infection control without reducing efficiency. Further enhancement in promulgating the advantages of Modified-Workflow is needed. References • NTWC ICN (2024). ICN Updates.
