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Carolyn Dawson: Hand Hygiene in Infection Control

Currently in her 3rd year, Carolyn is based in the Institute of Digital Healthcare at WMG.

Carolyn studied at the University of Warwick at Undergraduate and Graduate level, achieving both a BSc in Psychology and an MA in Organisation Studies. She went on to gain 6 years industrial experience working at a global laser manufacturing company as a Project Analyst before joining the PhD programme at WMG. In this role she was responsible for process-improvement projects across the Supply Chain, developing new processes and working on inter- and intra-departmental projects, gaining first-hand experience of the direct impact that behavioural and cultural themes can have on both day-to-day and long-term business outcomes.

Carolyn says: "Working as a Project Analyst allowed me to work with teams within different sectors of the Organisation, and face the challenges posed by the involvement of inter- and intra- departmental teams. My return to academia reflected an opportunity to apply the knowledge gained from both my academic and industrial experiences to a sector which held personal interest to me – that of Healthcare".

Carolyn's PhD project is based upon understanding the existing burden of monitoring Hand Hygiene compliance, analysing how technology is currently being applied to the field to improve the situation, and then questioning whether such applications are indeed a ‘useful’ solution in the eyes of the expert end-users (Healthcare workers). Of particular interest is the question of whether human behaviour offers the potential to bridge the gap left by current technology limitations.

According to the World Health Organisation's (2009) report, Hand Hygiene is the key factor in the cross-contamination which leads to HAI (Hospital Acquired Infection) outbreaks and empirical evidence in favour of this conclusion has built up strongly over the past 40 years.

Carolyn explains: "Whilst Direct Observation has well documented methodological flaws in terms of validity and thus data accuracy (e.g. the Hawthorne effect) it also poses a human burden factor - in this case involving clinical staff being involved in the collection, analysis and feedback phases of the Audit. Due to this Audits can only be performed at intervals throughout the year, and thus can only provide arguably limited indications of Hand Hygiene compliance rates.

Technology offers two potential roles within this field; one to improve compliance to Hand Hygiene, and the other is to reduce the burden of the Audit. In other industries technology has been successfully applied to ensure compliance to required cleanliness standards - for example at NASA in the USA.

Hand Hygiene has received the interest of technology developers, and various innovations have been launched which offer users the opportunity to increase Hand Hygiene Compliance within their organisation. However, during the process of a Systematic Review of Hand Hygiene Technologies (carried out by Dr Martinez-Solano, Professor Wyatt and myself) no examples of Hand Hygiene technologies that were able to detect, monitor, measure and provide feedback on performance at the 'WHO 5 Moments' were found.

Thus, this research explores whether there is a potential for technology of this ilk - to allow Hand Hygiene perfomance at the 'WHO 5 Moments' to be montiored, measured and the performance feedback - to reduce the current burden of Hand Hygiene Auditing, and ultimately to increase Hand Hygiene Compliance. Key to this research is exploring the views of Healthcare workers with regard to Hand Hygiene technologies, as part of the wider study".