More than rewards: Insights into a hospital infection prevention and control gamification strategy.

Abstract

Traditional infection prevention and control (IPC) education and training of healthcare workers (HCW) is expensive and rarely sustainable, gamification strategies support behaviour change by capitalizing on psychological drivers such as intrinsic and extrinsic motivation. However, little is known about which type of reward presentation best supports the engagement of HCW. This study aims to examine which reward strategy can facilitate engagement and acquisition of IPC knowledge. The study was performed in three gastroenterology wards, a palliative-care ward served as control. Endpoints on bed-occupancy, Alcohol-Based Hand Sanitizer (ABHS) consumption were collected during a two-month baseline period, number of right answers was gathered during the intervention phases and surveys on expectation and satisfaction were conducted pre and post intervention. The intervention of twice-weekly knowledge quizzes, employed loss aversion, standard reward, and in-game reward strategies. Multivariate analysis was used to analyze data on ABHS consumption and IPC knowledge. 105 HCW participated, leading to a 170% increase in the mean ABHS consumption between baseline and the last phase of the gamification. This represents a significant effect of the gamification phases (p < .05). However, no significant consumption difference was observed between the gamified wards (p > .05). Furthermore, Gamified strategies showed higher engagement than the control, though strategies of loss aversion and standard rewards did not display higher ABHS consumption or game engagement over gamification alone. The intervention effectively engaged medical and non-medical staff in IPC topics, positively influencing HCW workflow and increasing ABHS consumption. These findings highlight gamification as a promising approach for IPC education.