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.
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.
In July 2013, a large hospital in Greenville, South Carolina, experienced a cluster of six Clostridium difficile infections on a 32-bed unit for hematopoietic stem cell transplant (HSCT) patients. In prior months, the infection rate had ranged from 0–1 per month. Because HSCT patients are at greater risk of acquiring C. difficile—a spore forming bacteria—hospital policy calls for clinicians and staff members working on the unit to use soap and water for hand hygiene, not alcohol-based hand sanitizer. By giving staff real-time feedback on the use of soap vs. sanitizer and ensuring the proper protocol was followed, hand hygiene compliance increased significantly and rates of C. difficile dropped from 7.03/10,000 patient days to 2.38/10,000 patient days.
Robinson, N., Boeker, S., Steed, C., & Kelly, W. (2014, June). Innovative use of electronic hand hygiene monitoring to control a Clostridium difficile cluster on a hematopoietic stem cell transplant unit. Poster session presented at the meeting of APIC, Anaheim, CA.