Using a retrospective cohort design, researchers investigated whether implementation of a hand hygiene compliance system (HHCS) resulted in improved hand hygiene compliance and a reduction in common HAI rates. During the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences.
Saungi McCalla MSN, MPH, RN, CIC *, Maggie Reilly BSN, RN, Rowena Thomas BSN, RN, Dawn McSpedon-Rai RN. (2017) An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene. American Journal of Infection Control. Published online: January 27, 2017
Automated observations systems for monitoring hand hygiene facilitate more measurements than feasible with direct observation and may enhance performance. We report that an automated observation system with immediate feedback was associated with a rapid and durable improvement in hand hygiene compliance.
Heather Michael MD, Colette Einloth BA, Cynthia Fatica BSN, RN, CIC, Theresa Janszen BBA, Thomas G. Fraser MD. (2017). Durable improvement in hand hygiene compliance following implementation of an automated observation system with visual feedback American Journal of Infection Control 45 (2017) 311-3.
Patients continue to suffer preventable harm despite the pledge of healthcare students to “First, do no harm” and sincere efforts to improve patient safety. Healthcare-associated infections (HAIs) are a significant source of avoidable injuries and death. Hand hygiene protocols are known to prevent HAIs, but compliance rates remain low. Because the methods commonly used to measure compliance are unreliable, hospitals do not have accurate, dependable data. Even worse, direct observation, used traditionally by hospitals to measure hand hygiene, inflates compliance rates and imparts a false sense of security. Newly developed electronic monitoring systems can measure 100% of hand hygiene events accurately, reliably, and in real time. Eight companies [at press time; now expanded to 9] that offer electronic monitoring technologies have formed the Electronic Hand Hygiene Compliance Organization (EHCO) to reduce avoidable harm and eliminate unnecessary healthcare expense. EHCO promotes the adoption of new policies and guidelines for using electronic systems as the preferred way to measure hand hygiene compliance.
Alper, P. (2016), To do no harm, rethink how to measure hand hygiene. Patient Safety & Quality Healthcare, 13(3), 30–34. ￼
In July 2012, the Greenville Health System, a 746-bed teaching hospital in Greenville, South Carolina, implemented an electronic system for monitoring compliance with the World Health Organization’s My 5 Moments for Hand Hygiene. The system provides real-time validated data on hand hygiene compliance (HHC). Nurse managers on each unit were encouraged to use the data to drive change by sharing and discussing compliance rates with frontline staff members during monthly and quarterly quality meetings. Analysis of data from 23 inpatient units over 33 months showed a significant correlation between hand hygiene compliance and healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections. On a unit-by-unit basis, when HHC improved, MRSA infections decreased. During the study period, HHC improved by over 25% while MRSA infection rates declined 42%, representing $434,000 of cost avoided for the hospital.
Kelly, J. W., Blackhurst, D., McAtee, W., & Steed, C. (2016). Electronic hand hygiene monitoring as a tool for reducing health care-associated methicillin-resistant Staphylococcus aureus infection [Brief report]. American Journal of Infection Control, 44, 956–957.
Riverside Medical Center in Kankakee, Illinois, had tried different approaches to tracking hand hygiene compliance. Direct observation resulted in unreliable data and required excessive time and labor. Measuring how much hand gel was consumed was inefficient and controversial, with too much time spent training staff and arguing about the results. The compliance rate hovered around 32% for years. After installing an electronic hand hygiene compliance system in 2013 and supporting the system with strategic leadership goals and additional hand gel dispensers, the hospital wide compliance rate rose to 79% in 2015. During the same period, the rate of hospital-onset methicillin-resistant Staphylococcus aureus fell 50%, and the hospital’s penalty related to readmissions fell to zero.
Bouk, M., Mutterer, M., Schore, M., & Alper, P. (2016, June) Use of an electronic hand hygiene compliance system to improve hand hygiene, reduce MRSA, and improve financial performance. Poster session presented at the meeting of APIC, Charlotte, NC.