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Purpose Hand hygiene is a vital preventive measure against the novel coronavirus disease 2019 (COVID-19) infection. Though older people are at high risk of infection of COVID-19, there is still a lack of verification of hand sanitization and effective interventions to promote its implementation for older people. This study aimed to validate what kind of intervention can effectively promote hand hygiene among elderly individuals in Japanese day care centers, based on the hypothesis that a particular nudge will significantly promote hand hygiene. Methods We designed two types of interventions that have aspects of the nudge concept based on WHO Guidelines on Hand Hygiene in Health Care. The study was conducted with one-week observation and intervention periods excluding weekends, starting on February 11, 2023. Three groups were defined as follows: control (installation of hand sanitizer dispenser with a basic sign), reminder (additional visual cues using yellow curing tape), and institutional safety (sign appealing to protecting institutional safety by using hand sanitizer). Daily hand sanitizer usage was measured, and statistical analysis was performed using a one-way ANOVA for the number of uses before and after intervention. Results During the observation period, the average number of hand sanitizer pushes per person remained at 0.39 across all facilities. During the intervention period, control, reminder, and institutional safety groups showed increases of 1.13-fold, 1.31-fold, and 1.16-fold, respectively, revealing no significant difference. Conclusions Though these nudges were implemented according to WHO guidelines and the previous study, the older users of day care centers seemed not to react to these nudges significantly. The results underscore the need for tailored interventions to improve hand hygiene among the elderly in day care settings, contributing to the overall goal of preventing infectious diseases.
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Purpose The purpose of this study was to evaluate the changes in capabilities between the Generative Pre-trained Transformer (GPT)-3.5 and GPT-4 versions of the large-scale language model ChatGPT within a Japanese medical context. Methods The study involved ChatGPT versions 3.5 and 4 responding to questions from the 112th Japanese National Nursing Examination (JNNE). The study comprised three analyses: correct answer rate and score rate calculations, comparisons between GPT-3.5 and GPT-4, and comparisons of correct answer rates for conversation questions. Results ChatGPT versions 3.5 and 4 responded to 237 out of 238 Japanese questions from the 112th JNNE. While GPT-3.5 achieved an overall accuracy rate of 59.9%, failing to meet the passing standards in compulsory and general/scenario-based questions, scoring 58.0% and 58.3%, respectively, GPT-4 had an accuracy rate of 79.7%, satisfying the passing standards by scoring 90.0% and 77.7%, respectively. For each problem type, GPT-4 showed a higher accuracy rate than GPT-3.5. Specifically, the accuracy rates for compulsory questions improved from 58.0% with GPT-3.5 to 90.0% with GPT-4. For general questions, the rates went from 64.6% with GPT-3.5 to 75.6% with GPT-4. In scenario-based questions, the accuracy rates improved substantially from 51.7% with GPT-3.5 to 80.0% with GPT-4. For conversation questions, GPT-3.5 had an accuracy rate of 73.3% and GPT-4 had an accuracy rate of 93.3%. Conclusions The GPT-4 version of ChatGPT displayed performance sufficient to pass the JNNE, significantly improving from GPT-3.5. This suggests specialized medical training could make such models beneficial in Japanese clinical settings, aiding decision-making. However, user awareness and training are crucial, given potential inaccuracies in ChatGPT's responses. Hence, responsible usage with an understanding of its capabilities and limitations is vital to best support healthcare professionals and patients.