1008. Impact of an Electronic Hand Hygiene Monitoring System Trial on Hand Hygiene Compliance in a Surgical Intensive Care Unit (SICU) and General Medical Ward (GMW)
Session: Poster Abstract Session: Hand Hygiene 2012
Friday, October 19, 2012
Room: SDCC Poster Hall F-H
  • Ekahau poster ID week 10.2012 Final 2.pdf (462.5 kB)
  • Background: Observational surveys are the standard method for monitoring healthcare worker (HCW) hand hygiene compliance (HHC), but are time-consuming. Electronic hand hygiene monitoring systems offer the potential to monitor more hand-hygiene events with less effort and are also thought to improve compliance.  We evaluated the impact of an electronic monitoring system based on real-time location system (RTLS) technology on directly-observed HCW HHC. 

    Methods: We completed a before-after quasi-experimental survey of HHC as impacted by the RTLS system. A hospital employee, trained to observe HHC using WHO methods conducted surveys in a SICU and on a general medical ward (GMW) during a baseline period (May 16 – Dec 11 2011). From Dec 19, 2011 [IS1] – Mar 4, 2012 (study period), a majority of nurses and a limited number of other HCWs on the two units wore RTLS electronic badges. HHC was defined as using a dispenser at time of room entry (proxy for before touching patient) and at room exit (proxy for after touching patient or the environment). The trained observer continued observational surveys during the study period. Statistical analysis of time-series data including HHC rates was performed using Poisson regression models adjusting for correlation over time using an autoregressive correlation structure.

    Results: HCWs performed hand hygiene more often after touching the patient or patient’s environment than before touching patients in both units. During the entire pre-post observation period, there were significant trends in improved HHC in both SICU and GMW, which started prior to initiation of the RTLS system. These trends ranged from a 1% relative increase per week in exit compliance to a 7% relative increase in entry compliance per week, both in SICU. The initiation of electronic monitoring using the RTLS system was associated with a 36% decline in entry compliance rate (p=0.191) and 32% decline in the exit compliance (p<0.001).  The average accuracy of the badge RTLS system was 60%.       

    Conclusion: Based on observational surveys, HHC increased during the baseline period, but decreased somewhat when electronic monitoring was in use. HCW frustration with the accuracy highlights the importance of minimizing perceived false negatives with electronic monitoring systems.

    John M. Boyce, MD, FIDSA1,2, Timothea Cooper, RN3, Alison Lunde, BS3, Jun Yin, MS4 and James Arbogast, PhD5, (1)Yale University School of Medicine, New Haven, CT, (2)Medicine, Hospital of St. Raphael, New Haven, CT, (3)Medicine, Hospital of Saint Raphael, New Haven, CT, (4)University of Iowa, Iowa City, IA, (5)GOJO Industries, Akron, OH


    J. M. Boyce, Gojo Industries: Consultant, Consulting fee, Research grant and Research support

    T. Cooper, None

    A. Lunde, None

    J. Yin, None

    J. Arbogast, Gojo Industries: Employee, Salary

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