User centred design and nosocomials in surgical ICUs: A mobile application for peer monitoring and training in hand hygiene

Nosocomial infections are a global public health risk. In low and middle-income countries the problem is acute with very high infection rates commonly contributing to poor patient outcomes including mortality. Organisational, cultural, and individual factors have been identified in these high rates, with poor hand hygiene compliance amongst clinicians a major risk factor. New approaches to achieving clinician behaviour change are required. User-centred approaches have proven effective to engage and support changes in clinician behaviours through the use of electronic tools. This paper reports on the experience of co-designing and implementing a mobile application with clinicians to enhance hand hygiene compliance. The peer monitoring and training supported by the application aims to directly contribute to evidence on reductions in infection rates in two surgical ICUs in Sri Lanka.