Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals

Edmisten, Catherine; Hall, Charles N.; Kernizan, Lorna; Korwek, Kimberly; Preston, Aaron; Rhoades, Evan; Shah, Shalin; Spight, Lori; Stradi, Silvia; Wellman, Sonia; Zygadlo, Scott

doi:10.1016/j.ajic.2017.03.033

Cited by 37 publications

(44 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This sustained improvement supports the results reported by others. 26,36,37 Our experience with this program reinforced the findings of other studies that a multimodal, team-driven, friendly competition and positive-reinforcement-focused approach is crucial for improving hand hygiene, particularly with respect to peer influence and role modeling. 11,12,28,29,38 It also reflects the assertion outlined in other studies that multimodal interventions are necessary for sustained improvement.…”

Section: Discussionsupporting

confidence: 69%

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Knepper

Miller

Young

2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective: Hand hygiene adherence has been associated with reductions in nosocomial infection. We assessed the effect of improvements in electronically measured hand hygiene adherence on the incidence of hospital-acquired infections. Methods: This quasi-experimental study was conducted in a 555-bed urban safety-net level I trauma center. The preintervention period was January 2015 through June 2016. Baseline electronic hand hygiene data collection took place from April through June 2016. The intervention period was July 2016 through December 2017. An electronic hand hygiene system was installed in 4 locations in our hospital. Performance improvement strategies were implemented that included education, troubleshooting, data dissemination, and feedback. Adherence rates were tracked over time. Rates of hospital-acquired infections were evaluated in the intervention units and in control units selected for comparison. The intervention period was subdivided into the initial and subsequent 9-month periods and were compared to the baseline period. Results: Electronically measured hand hygiene rates improved significantly from baseline to intervention, from 47% 77% adherence. Rates >70% continued to be measured 18 months after the intervention. Interrupted time series analysis indicated a significant effect of hand hygiene on healthcare facility-onset Clostridioides difficile infection rates during the first 9 months of the intervention. This trend continued during the final 9 months of the intervention but was nonsignificant. No effects were observed for other hospital-acquired infection rates. Conclusions: Implementation of electronic hand hygiene monitoring and performance improvement interventions resulted in reductions in hospital-onset Clostridioides difficile infection rates.

show abstract

Section: Discussionsupporting

confidence: 69%

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Knepper

Miller

Young

2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Hanover Hospital's experience is consistent with other studies reporting that complementary activities such as goal setting, reward incentives and accountability can result in improved HH practices when added to an AHHMS or basic multimodal strategies recommended by the World Health Organization. 14,17,38 In conclusion, providing HCP with quantitative HH performance data from an AHHMS in combination with multiple supplementary promotional activities resulted in a significant and sustained increase in HH performance rates. Reductions in HAIs occurred but were not statistically significant.…”

Section: Discussionmentioning

confidence: 83%

Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections

Boyce¹,

Laughman

Ader

et al. 2019

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective:Determine the impact of an automated hand hygiene monitoring system (AHHMS) plus complementary strategies on hand hygiene performance rates and healthcare-associated infections (HAIs).Design:Retrospective, nonrandomized, observational, quasi-experimental study.Setting:Single, 93-bed nonprofit hospital.Methods:Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.Results:Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.Conclusion:Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.

show abstract

“…22 Possible next steps that could help Japanese hospitals achieve improved health care worker hand hygiene adherence include obtaining stronger government and hospital leadership support, 23 ensuring that all Japanese hospitals have an appropriate number of infection prevention specialists, 24 and possibly using electronic monitoring systems. 25 To improve the generally low adherence in emergency departments in Japan, education regarding the appropriate timing of hand hygiene may be required in such time-constrained environments. 26 Our study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Sakihama

Kayauchi

Kamiya

et al. 2020

American Journal of Infection Control

View full text Add to dashboard Cite

Background: Our goal was to evaluate the 5-year sustainability of a multimodal intervention that included a prize to the hospital with the highest overall hand hygiene adherence rates among health care workers. Methods: We conducted an observational study in 3 Japanese tertiary care hospitals using unobtrusive direct observation of physician and nurse hand hygiene adherence. Observations were performed by a trained observer on inpatient medical, surgical, intensive care, and emergency units. The primary outcome was hand hygiene adherence rates before patient contact. Secondary outcomes were health care worker survey responses to a World Health Organization (WHO) questionnaire on hand hygiene practices. Results: Hand hygiene adherence rates had improved significantly after the introduction of a multimodal intervention (based on principles recommend by the WHO) in 2012 and 2013 (from 18.0% pre-intervention to 32.7% 6 months post-intervention; P < .001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5 years after intervention; P = .53); however, substantial variability in hand hygiene adherence by unit and health care worker type was noted. Conclusions: A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention.

show abstract

Implementing an electronic hand hygiene monitoring system: Lessons learned from community hospitals

Cited by 37 publications

References 17 publications

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections

Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals

Contact Info

Product

Resources

About