Observer accuracy and behavior analysis: Data collection procedures on hand hygiene compliance in a neurovascular unit

• We examined data collection integrity of hand hygiene on a neurovascular unit
• We examined data collection integrity by manipulating the response effort involved in the data collection process
• Auditing behavior (results) changed when data collection involved increased response effort
• Results indicated that when response effort increased, compliant audits decreased and when response effort decreased, compliant audits increased
• These results suggest the need for standardizing reporting systems to ensure hand hygiene collection and reporting procedures are comparable across settings

BackgroundAlthough observational studies are popular, little has been done to study the integrity of human observers and the data collection process. Issues of data collection integrity threaten functional findings, leading to problematic interpretation and decreased replication. In our study the response effort associated with hand hygiene data collection in a hospital setting was manipulated using an altered data collection tool.MethodsA counterbalanced ABAB design was implemented across 2 semesters of a hand hygiene data collection practicum course.ResultsWhen response effort increased, compliant audits decreased and when response effort decreased, compliant audits increased. These results were statistically significant, with an overall level change z that had a P value of .001 (first semester) and .007 (second semester).ConclusionThese findings may warrant an increased awareness of data collection procedures where recording options include a less effortful response. The results of our study support basic research on response effort and choice behavior in an applied setting, bringing into question the integrity of data collection procedures and the integrity of the data collected. These results also suggest the need for standardizing reporting systems to ensure hand hygiene collection and reporting procedures are comparable across settings.