505. A Randomized Trial of a Reminder Feature to Increase Hand Hygiene Compliance as Measured by a Wireless, Automated, Monitoring System
Session: Poster Abstract Session: Infection Control and Skin Hygiene
Friday, October 21, 2011
Room: Poster Hall B1
Background: Hand hygiene (HH) is critical for prevention of healthcare associated infections. Few methods have been shown to successfully improve HH compliance. We implemented a wireless, automated system (HanGenix, Inc) that documents HH opportunities and events and also reminds clinicians to perform HH when an opportunity is not coupled with an event. We aimed to compare HH compliance rates with and without a reminder feature

Methods: Clinicians voluntarily wore badges sensing HH opportunities (entry into a patient zone) and events (use of soap or alcohol dispensers). Data were collected at baseline (without the reminder) and compared to directly observed HH compliance (5 moments as per WHO criteria). Then, the reminder feature (a 5 second beep) was activated on half the badges (intervention group) and remained silent (control group) on the other half and the badges were randomly allocated to clinicians using a random number list. Compliance rates were calculated by dividing the number of events by the number of opportunities and were compared between the intervention and control groups.

Results: Before randomization, in 78.52 hours of observation, a compliance rate of 44% was measured out of 622 opportunities. This compared to a rate of 90% compliance based on a sample of 50 conventional observations on the same ward. After randomization, 103.59 and 118.27 hours of observation were collected from the control and reminder groups, respectively. HH compliance was 40% out of 949 opportunities in the control group and 48% out of 745 opportunities in the reminder group, OR 1.43; 95% CI 1.17;1.75, p <.001.

Conclusion: The automated monitoring system was associated with lower HH compliance rates compared to direct observation but captured a much higher number of opportunities. This may be due to a greater Hawthorne effect with direct observation and the fact that not all automatically sensed opportunities (patient zone entry) corresponded with an activity requiring HH (WHO criteria). Significantly higher HH compliance rates were achieved with a reminder compared to no reminder. A system which provides immediate and direct feedback to individuals via this subtle reminder can be effective in improving HH compliance.

Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Kalpana Gupta, MD, MPH1,2, Norman Novack1, Matthiew Goulet1, MaryAnn Miller1, Judith Strymish, MD1,3 and VA Boston Infection Prevention Program1, (1)VA Boston Health Care System, West Roxbury, MA, (2)Boston University School of Medicine, Boston, MA, (3)Harvard Medical School, West Roxbury, MA


K. Gupta, None

N. Novack, None

M. Goulet, None

M. Miller, None

J. Strymish, None

V. B. Infection Prevention Program, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.