EHCO Alliance Calls for Change in Outdated Hand Hygiene Compliance Policy and New Guidelines to Improve Patient Safety

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. 

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System-wide Improvement of Hand Hygiene Compliance Reduces Healthcare-Associated MRSA Infections

Novant Health is a large healthcare system with facilities comprising 2,650 beds in North and South Carolina at the time of this study. In 2004, Novant’s executive team made hand hygiene compliance the system’s long-term corporate goal, having recognized that the system’s rate of healthcare-associated infections was below published best practices. Also in 2004, Novant experienced a MRSA outbreak that resulted in the death of a child. Novant implemented a comprehensive program of financial incentives, leadership support, and education to improve compliance across the system. As measured by direct observation, hand hygiene rates rose from baseline 49% to 90% in November 2006 and were sustained at more than 90% through the study’s completion in December 2008. MRSA rates were cut by approximately half during the same time period.

Lederer, J. W., Best, D., & Hendrix, V. (2009). A comprehensive hand hygiene approach to reducing MRSA health care-associated infections. The Joint Commission Journal on Quality and Patient Safety, 35(4), 180–185.

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Mathematical Modeling Estimates the Cost of MRSA Infections Associated With Hand Hygiene Noncompliance

Duke University Medical Center in Durham, North Carolina, used mathematical modeling to simulate the financial effect on the hospital of a single episode of hand hygiene noncompliance. The study found that a 1.0% increase in hand hygiene compliance resulted in annual savings of $39,650 to a 200-bed hospital. Conclusions: Hand hygiene noncompliance is associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings.

Cummings, K. L., Anderson, D. J., & Kaye, K. S. (2010). Hand hygiene noncompliance and the cost of hospital-acquired methicillin-resistant Staphylococcus aureus infection. Infection Control and Hospital Epidemiology, 13(4), 357–364.

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