The investigators long-term goal to establish sustainable, patient-centered interventions
at the patient level to engage patients in safety and prevention by offsetting barriers
such as physical and sensory limitations that prohibit older adults from actively
cleaning their hands independently. Unfortunately, older adults are at highest risk for
infections and yet while hand hygiene is the single most important way to prevent the
spread of infection, mechanisms for older adults to minimize personal risk for infections
is often overlooked. Many contamination elements exist in hospital settings and for older
adults encountering high-touch surfaces and medical devices that harbor pathogens that
lead to infections will occur. However, without assistance, hand-hygiene practice rates
are poor among hospitalized older adults' due to frailty, limited dexterity and mobility,
cognitive limitations, and risk of falling, which prohibits independent use of visible
hand- hygiene products (e.g., wall dispensers, towelettes, in-room sinks). New solutions
are necessary. Therefore, in this proposal, the investigators have updated this
investigator-developed, technology-enhanced patient hand hygiene system. Clean Hands
Accessible and Manageable for Patients (CHAMPs), the investigator-developed and pilot
tested bed rail-affixed hand-sanitizing dispenser, which features verbal, auditory and
visual reminders to remind patients to sanitize hands. The safe and easily accessible
motion-sensing system with usage tracking requires very little physical effort, as users
need only to be able to freely move upper extremities and reach over to the bed rail to
clean hands when prompted (e.g. before meal times). Pilot results among both a small
group of older adults and in a high-tech simulated environment demonstrated both efficacy
and feasibility of the intervention. In this 4-year project, the investigators propose a
large heterogeneous randomized controlled trial (RCT) comparing two groups of
hospitalized adults ≥ 65 years in two public hospitals, one group receives CHAMPs (n=125)
and the other is the usual-care (UC) group (n=125). Study investigators consists of early
and late stage investigators who have a successful record of working together and are
ready to address the following aims: (1) to determine the effect of CHAMPs as a method to
improve hand hygiene behavior and reduce patients' hand contamination, (2) assess the
implementation of the intervention and (3) examine factors that influence outcomes
associated with the intervention. The primary outcome is hand contamination as measured
by presence, type, and quantity of colony forming units located on participants' hands.
The research study staff's preliminary results offer promise that the CHAMPs
technology-enhanced intervention may be an effective approach to engage patients in
infection prevention as a solution to reduce colonization and infection rates among older
adults.This proposal aligns with all four goals of NIH/NIA's 2020-2025 strategic plan,
which is to improve the health, well-being, and independence of adults as age increases
and to prevent or reduce the burden of age-related diseases, disorders, and disabilities.