Although everyone knows hand hygiene is one of the most important steps for preventing the spread of infection; rates of hand hygiene in hospitals continue to be low. While the gold standard for monitoring hand hygiene compliance in hospitals has generally been visual observation, it often overestimates hand hygiene compliance rates. Therefore, many facilities don’t know they have a hand hygiene compliance problem!
A study was conducted to investigate the impact of electronic hand hygiene monitoring combined with a clinical hand hygiene improvement program on hand hygiene compliance rates. The study was conducted from June through October 2012 in Medical / Surgical and Infectious Disease units of a Fort Worth, TX hospital. The GOJO SMARTLINK activity monitoring system which monitors all patient room entries and exits (each one is considered a hand hygiene opportunity) and all hand hygiene events from automatic soap or sanitizer dispensers was installed. Compliance was measured as number of events / number of opportunities, and included visitors and staff, not just healthcare workers.
Baseline (before intervention) compliance measurements were taken from June 8-June 18. Then the study ran from June 19-September 9, and included implementation of a comprehensive hand hygiene program that included education, development of a hand hygiene improvement goal, leadership support and feedback for the staff. A post-study assessment followed to determine whether the changes in compliance rates were sustainable from September 10-October 28. There was a 92% increase in compliance rates during the study period. This difference was significant (P<0.0001).
Implementation of a hand hygiene program that includes a compliance activity monitoring system resulted in a significant, sustained improvement in hand hygiene compliance rates. This study may underestimate the actual compliance rate of the healthcare workers since patients and visitors are also tracked by the system, however the impact is likely minimal and would not be expected to substantially change compliance rates since the majority of room entries/exits will be healthcare workers. Use of electronic monitoring is a valuable tool for educating healthcare workers on their hand hygiene performance, tracking hand hygiene performance improvements. Installation of these systems should be considered in hospitals to get a more accurate picture of the hand hygiene compliance rates in their facility so that realistic performance improvement goals can be set and so staff have the information they need to work towards those goals.
Hand hygiene compliance rates continue to be covered in the media, most recently by the Wall Street Journal, in the article, "Why Hospitals Want Patients to Ask Doctors, 'Have You Washed Your Hands?'" There are solutions and education for hospitals and infection control preventionists to promote hand hygiene to decrease the spread of infection. For more information related to the hand hygiene products and systems used in the study, visit www.gojo.com/smartlink.