scholarly journals Electronic Monitoring of Individual Healthcare Workers’ Hand Hygiene Event Rate

2014 ◽  
Vol 35 (9) ◽  
pp. 1189-1192 ◽  
Author(s):  
Matthew P. Muller ◽  
Alexander I. Levchenko ◽  
Stanley Ing ◽  
Steven M. Pong ◽  
Geoff R. Fernie
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Event Rate ◽  
Individual Healthcare

scholarly journals 1187. Estimation of Individual Healthcare Workers’ Relative Hand Hygiene Compliance Using an Anonymous Electronic Monitoring System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S425-S426 ◽  
Author(s):  
Maxime-Antoine Tremblay ◽  
Mona Abou Sader ◽  
Yves Longtin
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Tertiary Care ◽  
Care Hospital ◽  
Z Score ◽  
Significant Difference ◽  
Z Scores ◽  
Individual Healthcare

Abstract Background The current hand hygiene (HH) auditing and feedback strategy include anonymized data collection using direct observation and feedback of aggregated data. We aimed to evaluate whether an anonymous (without wearable device) HH electronic monitoring system (EMS) could detect patterns associated with individual healthcare workers (HCWs) and estimate their relative HH performance. Methods Observational study of HH compliance via an EMS in 10 rooms in a tertiary care hospital. The EMS measures HH product dispenser activation (an indicator of HH events) as well as entries and exits from patient rooms (a surrogate of HH opportunities). HH rates were obtained by dividing the number of HH events by the number of opportunities. HH rates were aggregated at room-shift level (i.e., an 8-hour period for a single room). For each room-shift, the HH rate was converted to a Z score, which was then associated with the individual HCW assigned to that room-shift. The relative HH performance of individual HCWs was estimated by comparing the mean Z scores of each HCW with the rest of the group by the Student T-test, with a level of significance set at P < 0.001 after adjustment by Bonferroni’s correction. To investigate whether any association could be due to chance, we looked into the potential association between average Z scores and calendar days, as a counterexample. Results Over a 100-day period, there were 45 775 HH events and 136 821 opportunities (global compliance, 33%). Schedules were available for 2980 room-shifts. Fifty-four individual HCWs took part in at least one room-shift (average per HCW, 52 room-shifts; range 1–140). Eight HCWs (15%) had a mean Z score significantly above the group average (Figure 1, green boxes; mean Z score 0.71; range, 0.52 to 0.86; P < 0.001), whereas 9 HCWs (17%) had a significantly inferior Z score (Figure 1, red boxes; mean Z score -0.47, range -0.58 to -0.31, P < 0.001). In contrast, there was no significant difference in Z scores between calendar days (Figure 2; p >0.001). Conclusion Cross-linking a high-volume HH database with HCW schedules identified a significant association between individual HCWs and HH compliance in the rooms to which they were assigned. If confirmed in further studies, anonymous EMS could be used to provide HCWs with personalized relative HH compliance feedback. Disclosures All authors: No reported disclosures.

Measuring Healthcare Worker Hand Hygiene Activity: Current Practices and Emerging Technologies

2011 ◽  
Vol 32 (10) ◽  
pp. 1016-1028 ◽  
Author(s):  
John M. Boyce
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Electronic Monitoring ◽  
Monitoring Systems ◽  
Improve Hand Hygiene ◽  
Hand Hygiene Improvement ◽  
Gold Standard Method ◽  
Improvement Programs ◽  
Hygiene Compliance

Monitoring hand hygiene compliance and providing healthcare workers with feedback regarding their performance are considered integral parts of multidisciplinary hand hygiene improvement programs. Observational surveys conducted by trained personnel are currently considered the “gold standard” method for establishing compliance rates, but they are time-consuming and have a number of shortcomings. Monitoring hand hygiene product consumption is less time-consuming and can provide useful information regarding the frequency of hand hygiene that can be used to give caregivers feedback. Electronic counting devices placed in hand hygiene product dispensers provide detailed information about hand hygiene frequency over time, by unit and during interventions. Electronic hand hygiene monitoring systems that utilize wireless systems to monitor room entry and exit of healthcare workers and their use of hand hygiene product dispensers can provide individual and unit-based data on compliance with the most common hand hygiene indications. Some systems include badges (tags) that can provide healthcare workers with real-time reminders to clean their hands upon entering and exiting patient rooms. Preliminary studies suggest that use of electronic monitoring systems is associated with increased hand hygiene compliance rates and that such systems may be acceptable to care givers. Although there are many questions remaining about the practicality, accuracy, cost, and long-term impact of electronic monitoring systems on compliance rates, they appear to have considerable promise for improving our efforts to monitor and improve hand hygiene practices among healthcare workers.

scholarly journals Observational Bias Within Hospital-Wide Hand Hygiene Program

2020 ◽  
Vol 41 (S1) ◽  
pp. s333-s333
Author(s):  
Amy Marques ◽  
Robert Tucker ◽  
Michael Klompas
Keyword(s):  
Data Collection ◽  
Hand Hygiene ◽  
Patient Care ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Peer Group ◽  
Group Versus ◽  
Professional Group ◽  
Care Hospital ◽  
Peer Observations

Background: Hand hygiene (HH) is critical to prevent hospital-acquired infections. Running a successful HH program requires valid and accurate HH data to monitor the status and progress of HH improvement efforts. HH data are frequently subject to variable forms of bias, for which considerations must be made to enhance the validity of HH data. Objective: We assessed the extent to which observers may be prone to report more favorable HH rates when observing healthcare workers from the same professional group versus members of other job categories. Methods: We analyzed HH data from 48,543 electronically collected observations conducted by frontline healthcare workers in a 793-bed acute-care hospital from January 1, 2019, through July 31, 2019. All auditors received training on HH observations and proper use of the data collection application. Compliance data were sorted into peer versus nonpeer observations by profession. We compared HH compliance rates for members of each professional group when monitoring peers versus nonpeers. We further stratified results by ancillary professions (central transport, unit associates, food services, pharmacy, phlebotomy, rehabilitation services, and respiratory therapy) versus nonancillary professions (doctors, nurses, physician assistants, patient care assistants). Results: Of 12,488 ancillary observations, 7,184 (57.5%) were peer observations and 36,055 were nonancillary observations, of which 15,942 (44.2%) were peer observations. The percentage of peer-to-peer observations versus nonpeer observations varied by profession, ranging from 96% of central transport workers and 91% of environmental services observations to 21% of patient care assistants and 34% of physician’s assistants. Average compliance rates for peer versus nonpeer observations in ancillary groups were 98% (95% CI, 98.7%–99.2%) versus 83% (95% CI, 82.5%–84.5%). Average compliance rates nonancillary groups were 92% (95% CI, 92.0%–92.8%) for peers versus 88% (95% CI, 87.8%–88.7%) for nonpeers (Table 1). Conclusions: We documented a propensity for some categories of healthcare workers to record discrepant rates of HH compliance when observing members of the same peer group versus others. This effect was more pronounced amongst ancillary versus nonancillary services. This study adds to the literature of potential sources of bias in HH monitoring programs. Operational changes in HH program data collection may be warranted to try to mitigate these biases such as increasing the frequency of validation exercises conducted by nonaffiliated observers, weighting peer versus nonpeer observations differently, or switching to automated electronic monitoring systems.Funding: NoneDisclosures: None

Frequency of Use of Alcohol-Based Hand Rubs by Nurses: A Systematic Review

2016 ◽  
Vol 38 (2) ◽  
pp. 189-195 ◽  
Author(s):  
John M. Boyce ◽  
Philip M. Polgreen ◽  
Mauricio Monsalve ◽  
David R. Macinga ◽  
James W. Arbogast
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Intensive Care Unit ◽  
Review Of Literature ◽  
Frequent Use ◽  
Frequency Of Use ◽  
The Us ◽  
Medical Intensive Care ◽  
Hygiene Compliance ◽  
Individual Healthcare

BACKGROUNDRecently, the US Food and Drug Administration requested that a “maximal use” trial be conducted to ensure the safety of frequent use of alcohol-based hand rubs (ABHRs) by healthcare workers.OBJECTIVETo establish how frequently volunteers should be exposed to ABHR during a maximal use trial.DESIGNRetrospective review of literature and analysis of 2 recent studies that utilized hand hygiene electronic compliance monitoring (ECM) systems.METHODSWe reviewed PubMed for articles published between 1970 and December 31, 2015, containing the terms hand washing, hand hygiene, hand hygiene compliance, and alcohol-based hand rubs. Article titles, abstracts, or text were reviewed to determine whether the frequency of ABHR use by healthcare workers was reported. Two studies using hand hygiene ECM systems were reviewed to determine how frequently nurses used ABHR per shift and per hour.RESULTSOf 3,487 citations reviewed, only 10 reported how frequently individual healthcare workers used ABHR per shift or per hour. Very conservative estimates of the frequency of ABHR use were reported owing to shortcomings of the methods utilized. The greatest frequency of ABHR use was recorded by an ECM system in a medical intensive care unit. In 95% of nursing shifts, individual nurses used ABHR 141 times or less per shift, and 15 times or less per hour.CONCLUSIONSHand hygiene ECM systems established that the frequency of exposure to ABHRs varies substantially among nurses. Our findings should be useful in designing how frequently individuals should be exposed to ABHR during a maximal use trial.Infect Control Hosp Epidemiol 2017;38:189–195

scholarly journals Large-Scale Analysis of Hand Hygiene Frequency Across Healthcare Facilities Varying in Key Hospital Characteristics

2020 ◽  
Vol 41 (S1) ◽  
pp. s448-s448
Author(s):  
Jessica Albright ◽  
Bruce White ◽  
Pete Carlson ◽  
Cheryl Littau
Keyword(s):  
Hand Hygiene ◽  
Healthcare Worker ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Small Sample ◽  
Healthcare Facilities ◽  
Hygiene Practices ◽  
Area Classification ◽  
Hospital Characteristics

Background: Hand hygiene by healthcare personnel is a critical infection prevention intervention. Direct observation, the most widely utilized method to observe hand hygiene practices, often provides an incomplete picture due to small sample size and altered behavior in the presence of observers. A growing number of healthcare facilities are employing electronic hand hygiene monitoring systems to capture overall compliance rates. These electronic systems can provide a wealth of data on hand hygiene practices within and across healthcare facilities. Objective: We used high-accuracy electronic monitoring data to perform a detailed analysis of hand hygiene practices across numerous facilities that varied in key hospital characteristics. Methods: In total, 11 tertiary-care facilities were equipped with an electronic hand hygiene monitoring system. Hospitals varied in size, region, area classification (urban vs rural), acuity level, and teaching status. The electronic monitoring system was composed of uniquely assigned employee badges and electronically monitored dispensers. Every recorded dispensing event was time stamped and associated with a specific healthcare worker, the location of the dispenser, and the specific product being dispensed (ie, alcohol-based hand rub [ABHR] or hand soap). The total number of dispensing events for each product type and the total number of hours worked were calculated for each healthcare worker and were used to determine hand hygiene frequency. Hospital attributes, such as size and area classification, were obtained from publicly available sources including but not limited to facility-owned websites and CMS data. Results: More than 15.7 million hand hygiene events, performed by nearly 11,000 healthcare workers, were captured by the electronic monitoring system and were included in the analysis. Overall, median hand hygiene frequency was 4.1 events per hour and ranged from 2.0 events per hour to 5.6 events per hour, depending on the facility. ABHR use (median, 3.6 events per hour) was more frequent than handwashing (median, 0.4 events per hour). Hospitals included in the analysis ranged from small (<20 beds) rural facilities to large (>600 beds) academic hospitals and provided a variety of services from general medical-surgical treatment to intensive care. Interfacility differences in observed hand hygiene frequency were analyzed. Conclusions: The current analysis reinforces and builds upon previous work that examined a smaller subset of 5 hospitals located in a single geographic region. Combined, these datasets represent >20 million hand hygiene events among ∼15,000 healthcare workers from 16 unique healthcare facilities. This analysis provides detailed information about hand hygiene practices across a diverse set of healthcare facilities.Funding: Ecolab, Inc, provided support for this study.Disclosures: Jessica Carol Albright and Cheryl A Littau report salary from Ecolab.

scholarly journals Healthcare workers' attitudes towards hand-hygiene monitoring technology

2019 ◽  
Vol 102 (4) ◽  
pp. 413-418 ◽  
Author(s):  
C. Tarantini ◽  
P. Brouqui ◽  
R. Wilson ◽  
K. Griffiths ◽  
P. Patouraux ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Monitoring Technology

scholarly journals Hand Hygiene Compliance Study at a Large Central Hospital in Vietnam

2019 ◽  
Vol 16 (4) ◽  
pp. 607 ◽  
Author(s):  
Cam Le ◽  
Erik Lehman ◽  
Thanh Nguyen ◽  
Timothy Craig
Keyword(s):  
Quality Assurance ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Medical Center ◽  
Compliance Rate ◽  
World Health ◽  
Limiting Factors ◽  
Cultural Attitudes ◽  
Knowledge And Attitude ◽  
Hygiene Compliance

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.

scholarly journals Hand hygiene and the sequence of patient care

2021 ◽  
pp. 1-6
Author(s):  
Nai-Chung Chang ◽  
Michael Jones ◽  
Heather Schacht Reisinger ◽  
Marin L. Schweizer ◽  
Elizabeth Chrischilles ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Patient Care ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Resistant Bacteria ◽  
Surgical Intensive Care ◽  
Hygiene Compliance ◽  
Hand Hygiene Opportunity

Abstract Objective: To determine whether the order in which healthcare workers perform patient care tasks affects hand hygiene compliance. Design: For this retrospective analysis of data collected during the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, we linked consecutive tasks healthcare workers performed into care sequences and identified task transitions: 2 consecutive task sequences and the intervening hand hygiene opportunity. We compared hand hygiene compliance rates and used multiple logistic regression to determine the adjusted odds for healthcare workers (HCWs) transitioning in a direction that increased or decreased the risk to patients if healthcare workers did not perform hand hygiene before the task and for HCWs contaminating their hands. Setting: The study was conducted in 17 adult surgical, medical, and medical-surgical intensive care units. Participants: HCWs in the STAR*ICU study units. Results: HCWs moved from cleaner to dirtier tasks during 5,303 transitions (34.7%) and from dirtier to cleaner tasks during 10,000 transitions (65.4%). Physicians (odds ratio [OR]: 1.50; P < .0001) and other HCWs (OR, 2.15; P < .0001) were more likely than nurses to move from dirtier to cleaner tasks. Glove use was associated with moving from dirtier to cleaner tasks (OR, 1.22; P < .0001). Hand hygiene compliance was lower when HCWs transitioned from dirtier to cleaner tasks than when they transitioned in the opposite direction (adjusted OR, 0.93; P < .0001). Conclusions: HCWs did not organize patient care tasks in a manner that decreased risk to patients, and they were less likely to perform hand hygiene when transitioning from dirtier to cleaner tasks than the reverse. These practices could increase the risk of transmission or infection.

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