314. A prospective controlled trial of an Electronic Hand Hygiene Reminder System
Session: Poster Abstract Session: Hand Hygiene in Healthcare Settings
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C

Background: The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance by healthcare workers; although information on their efficacy is currently limited. We have prospectively assessed the utility of one system in an ICU setting in an academic tertiary care medical center. The tested system features an electronic network of hand hygiene dispensers and room entry-exit monitors to monitor activities. Reminders included room entry/exit chimes, real time computer monitor feedback displays of unit-wide hand hygiene performance, and performance reports to managers.

Methods: A longitudinal prospective controlled clinical trial was performed in 2 medical ICUs that have comparable patient populations, healthcare worker staffing, and physical layouts.  The 16 bed test ICU was monitored through 5 phases:  1) baseline period with no reminders (6 weeks), 2) use of entry/exit chime reminders alone (5 weeks), 3) use of entry/exit chimes, computer monitor feedback display reminders, and performance reports to managers (5 weeks), 4) use of computer monitor feedback display reminder and performance reports to managers (5 weeks), and 5) a follow up period without reminders (4 weeks). Hand hygiene events of the second 15 bed control ICU were monitored without the use of any reminder system.

Results: Over a 171 day trial there were 277,434 hand hygiene events in the test ICU and 205,202 hand hygiene events in the control ICU. In the test ICU the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) during the third phase with the use of entry/exit chimes, computer monitor feedback, and manager reports (P<0.001), and the ratio of hand hygiene to room entry/exit events increased from 26.1% to 36.6% (40% increase, P<0.001). The performance returned to baseline (1473 hand hygiene events per day) during the final follow up phase. There were no significant changes in hand hygiene activity in the control ICU during the course of the trial.

Conclusion: This prospective controlled trial shows that an electronic hand hygiene reminder system that provides feedback on overall unit-wide hand hygiene activity can significantly increase hand hygiene activity in an ICU setting.

Richard T. Ellison III, MD1, Elke Rundensteiner, PhD2, Constance Barysauskas, MS3, Di Wang, Ph.D2 and Bruce Barton, PhD3, (1)Medicine, University of Massachusetts Medical School, Worcester, MA, (2)Computer Science, Worcester Polytechnic Institute, Worcester, MA, (3)Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA


R. T. Ellison III, University of Massachusetts: Dr. Rundensteiner, Dr Wang and I have submitted a patent application on the design of the software used for the electronic hand hygiene reminder system, a patent application has been submitted for software system used in the electronic hand hygiene reminder system
Ultraclenz, LLC: Collaborator, Research support
National Institutes of Health: Grant Investigator, Research grant

E. Rundensteiner, None

C. Barysauskas, None

D. Wang, None

B. Barton, None

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