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An Electronic Hand Hygiene Surveillance Device: A Pilot Study Exploring Surrogate Markers for Hand Hygiene Compliance

Published online by Cambridge University Press:  02 January 2015

Andrew G. Sahud ,
Nitin Bhanot ,
Anita Radhakrishnan ,
Rajinder Bajwa ,
Harish Manyam  and
James Christopher Post
Andrew G. Sahud*
Affiliation:
Division of Infectious Diseases, Allegheny General Hospital, Pittsburgh, Pennsylvania
Nitin Bhanot
Affiliation:
Division of Infectious Diseases, Allegheny General Hospital, Pittsburgh, Pennsylvania
Anita Radhakrishnan
Affiliation:
Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania
Rajinder Bajwa
Affiliation:
Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania
Harish Manyam
Affiliation:
Department of Internal Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania
James Christopher Post
Affiliation:
Department of Pediatric Otolaryngology, Allegheny General Hospital, Pittsburgh, Pennsylvania
*
Division of Infectious Diseases, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, (asahud@wpahs.org)
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Extract

Objective.

To evaluate the feasibility of using an electronic hand hygiene surveillance and feedback monitoring device.

Design.

A 2-phase pilot study included initial direct observation of hand hygiene practices as part of routine hospital quality assurance (phase I) and subsequent monitoring using an electronic hand hygiene surveillance device (phase II).

Setting.

A 700-bed tertiary care teaching hospital.

Participants.

Phase I included a convenience sample of healthcare workers. Phase II included 7 medical interns and 7 registered nurses recruited through email and at work-related meetings.

Methods.

During phase I, healthcare workers were directly observed at patient room entry and exit during the period April through November 2008. During phase II, hand hygiene data were gathered through indirect observation using the electronic device during a 4-week period in August 2009. Twenty patient rooms were fitted with electronic trigger devices that signaled a reader unit worn by participants when they entered the room, and 70 dispensers for liquid soap or hand sanitizer were fitted with triggers that signaled the reader unit when the dispenser was used. The accuracy of the devices was checked by the principal investigator, who manually recorded his room entries and exits and dispenser use while wearing a reader unit.

Results.

During phase I, hand hygiene occurred before room entry for 95 (25.1%) and after room exit for 149 (39.4%) of 378 directly observed patient room visits, for a cumulative composite compliance rate of 32.3%. Among the 378 room visits, 347 (91.8%) involved contact with the patient and/or environment. During phase II, electronic monitoring revealed a cumulative composite compliance rate of 25.5%. The electronic device captured 61 (98%) of 62 manually recorded room entries and 133 (95%) of 140 manually recorded dispensing events.

Conclusions.

The electronic hand hygiene surveillance device seems to be a practical method for routinely monitoring hand hygiene compliance in healthcare workers.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 6 , June 2010 , pp. 634 - 639
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

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References

1.Pittet, D. Compliance with hand disinfection and its impact on hospital-acquired infections. J Hosp Infect 2001;48(suppl A):S40–S46.CrossRefGoogle ScholarPubMed
2.Boyce, JM, Pittet, D; Healthcare Infection Control Practices Advisory Committee; HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Recomm Rep 2002;51(RR-16):1–45.Google ScholarPubMed
3.Pittet, D, Allegranzi, B, Boyce, J. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol 2009;30:611–622.Google Scholar
4.Pittet, D, Simon, A, Hugonnet, S, Pessoa-Silva, CL, Sauvan, V, Perneger, TV. Hand hygiene among physicians: performance, beliefs, and perceptions. Ann Intern Med 2004;141:1–8.Google Scholar
5.Nouira, A, Ounis, H, Khediri, M, Helali, R, Bannour, W, Njah, M. Healthcare workers' hand hygiene: compliance of the recommendations [in French]. Tunis Med 2008;86:451–456.Google Scholar
6.Dierssen-Sotos, T, Robles-Garcia, M, Valbuena-Moya, S. Hand hygiene: experience in two Spanish autonomous regions [in Spanish]. Med Clin (Bare) 2008;131 (suppl 3):60–63.Google Scholar
7.The Joint Commission. Measuring hand hygiene adherence: overcoming the challenges. The Joint Commission Web site. http://www.jointcom mission.org/NR/rdonlyres/68B9CB2F-789F-49DB-9E3F-2FB387666BCC/0/hh_monograph.pdf. Published 2009. Accessed September 14, 2009.Google Scholar
8.Heseltine, P. Why don't doctors and nurses wash their hands? Infect Control Hosp Epidemiol 2001;22:199–200.Google Scholar
9.O'Boyle, C, Henly, S, Larson, E. Understanding adherence to hand hygiene recommendations: the theory of planned behavior. Am J Infect Control 2001;29:352–360.CrossRefGoogle ScholarPubMed
10.Maury, E, Moussa, N, Lakermi, C, Barbut, F, Offenstadt, G. Compliance of health care workers to hand hygiene: awareness of being observed is important. Intensive Care Med 2006;32:2088–2089.Google Scholar
11.Fries, J, Hlady, C, Herman, T, et al. A low-cost non-RFID based method for automated monitoring of hand hygiene compliance. In: Program and abstracts of the 19th Annual Scientific Meeting of the Society for Health-care Epidemiology of America; March 19-22, 2009; San Diego, CA. Abstract 123.Google Scholar
12.Broughall, JM, Marshman, C, Jackson, B, Bird, P. An automatic monitoring system for measuring handwashing frequency in hospital wards. J Hosp Infect 1984;5:447–453.Google Scholar
13.Boyce, JM, Cooper, T, Dolan, MJ. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use. Infect Control Hosp Epidemiol 2009;30:1090–1095.Google Scholar
14.Armellino, D, Farber, B, Hussain, E, Schilling, M, Senicola, W. The effect of real-time remote video monitoring with feedback on healthcare worker hand hygiene in critical care. In: Interscience Conference on Antimicrobial Agents and Chemotherapy; September 13, 2009; San Francisco, CA. Abstract K-518.Google Scholar
15.Sahud, AG, Bhanot, N. Measuring hand hygiene compliance: a new frontier for improving hand hygiene [letter]. Infect Control Hosp Epidemiol 2009;30:1132.Google Scholar
16.Gale, EA. The Hawthorne studies-a fable for our times? QJM 2004;97: 439–449.CrossRefGoogle ScholarPubMed