HandHero: Feasibility and Acceptability of a Serious Game to Support Patient Companions' Hand Hygiene: A Single-Group...

Adherence to hand hygiene guidelines is critical for hospital patient companions to prevent healthcare-associated infections. The use of technology in training programmes has shown promise in improving hand hygiene compliance by enhancing the understanding of procedures among patients, visitors, patient companions and caregivers.

This pilot study assessed whether HandHero, a serious game designed to support hand hygiene, could be delivered to patient companions in a hospital ward, and whether they found it acceptable.

A single-group pilot study was conducted in an infectious diseases ward. Patient companions completed a demographics form and an information form on hand hygiene based on the WHO 'My Five Moments for Hand Hygiene', then played HandHero, a serious game developed on the Genially platform. The Gameful Experience Scale was administered the following day. Hand hygiene was observed by two trained nursing students using the WHO observation method, once before and once after serious game.

Of the 30 patient companions approached, 27 participated (90%), and all completed the game in 7 to 10 min; 5 (18.5%) chose to play a second time. The gameful experience was rated favourably (GAMEX total 94.2 ± 18.9). Overall observed compliance was 66.7% before the serious game session and 65.2% after. Compliance was higher after the session at 'before patient contact' (74.1% to 88.9%) and lower at 'after patient contact' (70.4% to 55.6%) and 'after body fluid exposure risk' (74.1% to 66.7%).

Delivering HandHero in this setting was feasible, and the game was well received by patient companions, a group that receives little infection-prevention training. The pre-post differences in observed compliance were mixed and, in the absence of a control group, cannot support any conclusion about effect.