504. Validation of an Automated System for Monitoring Hand Hygiene Compliance
Session: Poster Abstract Session: Infection Control and Skin Hygiene
Friday, October 21, 2011
Room: Poster Hall B1


Automated systems for monitoring of hand hygiene (HH) behavior have recently been reported to significantly improve compliance.  However, these reports have not included validation for accuracy despite the technical difficulties in using automated systems to measure human behavior.  In order to be both accepted by healthcare providers and useful compliance monitors, such systems must be exceptionally reliable and minimally intrusive. 


An automated system for monitoring HH (Proventix, Birmingham AL) was installed in the intensive care units of two academic medical centers. Healthcare providers (HCP) wear a badge containing a unique identifier such that each room entry, exit, and HH events can be attributed to a single individual by readers adjacent to each soap and alcohol-based hand rub (ABHR) dispenser.  The aim of this project was to assess the system's accuracy in measuring HH events for a number of common scenarios thought to affect performance. For validation of accuracy, participants followed a planned path through the units entering each room and using each dispenser while wearing a badge.  Data from the electronic readers were compared to the actual behavior of the participants to determine accuracy. Fisher's exact or chi square were used for comparisons.


There were no conflicts with medical devices or other technology at either site. Accuracy was significantly different if the badge was worn on the lapel compared with badge worn on the lower pocket of a white coat (p< 0.001).  When reaching to the side to use a dispenser, wearing the badge on the ipsilateral lapel was significantly more accurate than wearing it on the contralateral side (p = 0.05).  One badge was found to be non-functional (0 events recorded) and was excluded from the data.  See figure 1.

Figure 1.jpg


Automated HH monitoring systems may offer a safe and reliable method of measuring individual hand hygiene compliance.  However, accuracy can be affected by a number of factors.  The discovery of a dysfunctional badge is further evidence that validation testing must be done prior to implementation of such systems.  Use of inaccurate data could affect outcomes of intervention studies or tolerability by HCPs.

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

Emily Landon Mawdsley, MD1, Heather Limper, MPH2, Lisa Pineles, MS3, Stephen Weber, MD, MS4,5 and Daniel Morgan, MD3, (1)Infectious Diseases & Global Health, University of Chicago, Chicago, IL, (2)University of Chicago, Chicago, IL, (3)Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, (4)Medicine, Infectious Diseases and Global Health, University of Chicago Medical Center, Chicago, IL, (5)University of Chicago, Atlanta, GA


E. Landon Mawdsley, Proventix: speaker, Speaker honorarium

H. Limper, None

L. Pineles, None

S. Weber, None

D. Morgan, 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.