Abstract
Hand hygiene is widely recognized as an important measure to prevent the transmission of microorganisms that may be involved in healthcare-associated infections. Yet correct hand hygiene remains challenging and healthcare providers struggle to improve adherence. While seemingly straightforward, performing hand hygiene at the right indication using the right technique becomes difficult within the context of complex work processes. We believe that an important barrier to hand hygiene is the invisible nature of microorganisms and delayed expression of healthcare associated infections. This delayed or missing feedback makes it difficult to associate unsafe behaviors with their negative consequences. In this chapter, we describe an application of experiential learning theory to guide the development of a virtual reality hand hygiene trainer in which visual feedback about microorganism transmission and infectious outcomes are introduced in the virtual environment. With this immersive trainer, our aim is to enhance experiential learning and increase intrinsic motivation to perform hand hygiene.
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References
Allegranzi, B., Pittet, D.: Role of hand hygiene in healthcare-associated infection prevention. J. Hospital Infect. 73(4), 305–315 (2009)
Bertrand, J., Babu, S.V., Gupta, M., Segre, A.M., Polgreen, P.: A 3D virtual reality hand hygiene compliance training simulator. In: Scientific Meeting of the Society for Healthcare Epidemiology of America (2011)
Bertrand, J., Babu, S.V., Polgreen, P., Segre, A.: Virtual agents based simulation for training healthcare workers in hand hygiene procedures. In: International Conference on Intelligent Virtual Agents, pp. 125–131 (2010)
Clack, L., Wenger, M., Sax, H.: Virtual reality enhanced behaviour—Change training for healthcare-associated infection prevention. Front. Publ. Health 45 (2017)
Clack, L., Scotoni, M., Wolfensberger, A., Sax, H.: V “First-person view” of pathogen transmission and hand hygiene—Use of a new head-mounted video capture and coding tool. Antimicrob. Resist. Infect. Control 108(6) (2017)
Clack, L., Hirt, C., Wenger, M., Saleschus, D., Kunz, A., Sax, H: VIRTUE—A virtual reality trainer for hand hygiene. In: 9th IEEE International Conference on Information, Intelligence, Systems and Applications (2018)
De Freitas, S., Neumann, T.: The use of ‘exploratory learning’ for supporting immersive learning in virtual environments. Comput. Educ. 52(2), 343–352 (2009)
Erasmus, V., Daha, T.J., Brug, H., Richardus, J.H.K., Behrendt, M.D., Vos, M.C., van Beeck, E.F.: Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect. Control Hospital Epidemiol. 31(3), 283–294 (2010)
Harbarth, S., Sax, H., Gastmeier, P.: The preventable proportion of nosocomial infections: an overview of published reports. J. Hospital Infect. 54(4), 258–266 (2003)
Higgins, A., Hannan, M.M.: Improved hand hygiene technique and compliance in healthcare workers using gaming technology. J. Hospital Infect. 84(1), 32–37 (2013)
Hoffman, H., Vu, D.: Virtual reality: teaching tool of the twenty-first century? Acad. Med. 72(12), 1076–1081 (1997)
Kolb, D.A.: Experiential Learning. Englewood Cliffs (1984)
Lane, S., Strauss, K., Coyne, M.: Systems and methods for improving hand hygiene compliance. US Patent 6,975,231 (2005)
Larrue, F., Sauzeon, H., Wallet, G., Foloppe, D., Cazalets, J.R., Gross, C., N’Kaoua, B.: Influence of body-centered information on the transfer of spatial learning from a virtual to a real environment. J. Cogn. Psychol. 26(8), 906–918 (2014)
Larson, E.L., Quiros, D., Lin, S.X.: Dissemination of the CDC’s hand hygiene guideline and impact on infection rates. Am. J. Infect. Control 35(10), 666–675 (2007)
Marra, A.R., Zinsly Sampaio Camargo, T., Magnus, T.P., Blaya, R., dos Santos, G.B., Guastelli, L.R., et al: The use of real-time feedback via wireless technology to improve hand hygiene compliance. Am. J. Infect. Control 42(6), 608–611 (2014)
Michie, S., Van Stralen, M.M., West, R.: The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement. Sci. 6(1), 42 (2011)
Mook, D.G.: The Organization of Action. WW Norton (1987)
Nescher, T., Huang, Y.Y., Kunz, A.: Planning redirection techniques for optimal free walking experience using model predictive control. In: IEEE Symposium on 3D User Interfaces, pp. 111–118 (2014)
Nevo, I., Fitzpatrick, M., Thomas, R.-E., Gluck, P.A., Lenchus, J.D., Arheart, K.L., Birnbach, D.J.: The efficacy of visual cues to improve hand hygiene compliance. Simul. Healthcare 5(6), 325–331 (2010)
Nicol, P.W., Donovan, R.J., Wynaden, D., Cadwallader, H.: The power of vivid experience in hand hygiene compliance. J. Hospital Infect. 72(1), 36–42 (2009)
O’boyle, C.A., Henly, S.J., Larson, E.: Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am. J. Infect. Control 29(6), 352–360 (2001)
Pittet, D., Simon, A., Hugonnet, S., Pessoa-Silva, C.L., Sauvan, V., Perneger, T.V.: Hand hygiene among physicians: performance, beliefs, and perceptions. Ann. Internal Med. 141(1), 1–8 (2004)
Razzaque, S., Kohn, Z., Whitton, M.C.: Redirected walking. In: Proceedings of EUROGRAPHICS, vol. 9, 105–106 (2001)
Ruddle, R.A., Volkova, E., Bülthoff, H.H.: Walking improves your cognitive map in environments that are large-scale and large in extent. ACM Trans. Comput.-Hum. Interact. (TOCHI’11) 18(2), 10:1–10:20 (2011)
Rudolph, J.W., Simon, R., Raemer, D.B., Eppich, W.J.: Debriefing as formative assessment: closing performance gaps in medical education. Acad. Emerg. Med. 15, 1010–1016 (2008)
Sax, H., Allegranzi, B., Uckay, I., Larson, E., Boyce, J., Pittet, D.: My five moments for hand hygiene: a user-centred design approach to understand, train, monitor and report hand hygiene. J. Hospital Infect. 67(1), 9–21 (2007)
Sax, H., Clack, L.: Mental models: a basic concept for human factors design in infection prevention. J. Hospital Infect. 89(4), 335–339 (2015)
Sax, H., Longin, Y: Immersive hand hygiene trainer for physicians–a story-based serious game. In: BMC Proceedings, vol. 89, no. O31. BioMed Central (2011)
Saxena, N., Kyaw, B.M., Vseteckova, J., Dev, P., Paul, P., Lim, K.T.K., Kononowicz, A., Masiello, I., Tudor Car, L., Nikolaou, C.K., Zary, N., Car, J. : Virtual reality environments for health professional education (protocol). Cochrane Database Syst. Rev. 2 (2016)
Schreiber, P., Sax, H., Wolfensberger, A., Clack, L., Kuster, S.: Swissnoso: the preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis. Infect. Control Hospital Epidemiol. (in press), Presence (2018)
Stewardson, A.J., Sax, H., Gayet-Ageron, A., Touveneau, S., Longtin, Y., Zingg, W., Pittet, D.: Enhanced performance feedback and patient participation to improve hand hygiene compliance of health-care workers in the setting of established multimodal promotion: a single-centre, cluster randomised controlled trial. Lancet Infect. Dis. 16(12), 1345–1355 (2016)
Umscheid, C.A., Mitchell, M.D., Doshi, J.A., Agarwal, R., Williams, K., Brennan, P.J.: Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect. Control Hospital Epidemiol. 32(2), 101–114 (2011)
Usoh, M., Arthur, K., Whitton, M.C., Bastos, R., Steed, A., Slater, M., Brooks Jr., F.P.: Walking \(>\) walking-in-place \(>\) flying, in virtual environments. In: Proceedings of the 26th Annual Conference on Computer Graphics and Interactive Techniques, pp. 359–364 (1999)
World Health Organization: Report on the Burden of Endemic Healthcare-Associated Infection Worldwide (2011)
Zank, M., Kunz, A.: Where are you going? Using human locomotion models for target estimation. Vis. Comput. Int. J. Comput. Graph. 32(10), 1323–1335 (2016)
Zank, M., Kunz, A.: Optimized graph extraction and locomotion prediction for redirected walking. In: IEEE Symposium on 3D User Interfaces, pp. 120–129 (2017)
Zarb, P., et al.: The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Eurosurveillance 17(46), 20316 (2012)
Acknowledgements
This project has been generously supported by a donation from Dr. Hans-Peter Wild to the University Hospital Zurich Foundation. We would further like to acknowledge Dirk Saleschus, project manager, and Marcel Wenger, innovation manager, for their contributions to this work.
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Clack, L., Hirt, C., Kunz, A., Sax, H. (2021). Experiential Training of Hand Hygiene Using Virtual Reality. In: Brooks, A.L., Brahman, S., Kapralos, B., Nakajima, A., Tyerman, J., Jain, L.C. (eds) Recent Advances in Technologies for Inclusive Well-Being. Intelligent Systems Reference Library, vol 196. Springer, Cham. https://doi.org/10.1007/978-3-030-59608-8_3
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