312. Assessing an Automated Group Monitoring and Feedback System for Hand Hygiene
Session: Poster Abstract Session: Hand Hygiene in Healthcare Settings
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Poster IDWeek2013.pdf (294.7 kB)
  • Background: Dispensers for hand hygiene (HH) products that can electronically capture HH events have the potential to improve HH compliance as such systems can be used to provide feedback to healthcare workers (HCWs). Our aim was to examine the impact of an automated HH monitoring and feedback system on HH compliance rates in a community hospital.

    Methods:  In December 2011, an electronic monitoring system was installed throughout a 140-bed community hospital. The system monitors the use of alcohol hand rub and soap, but does not identify individual HCWs. HH rates were calculated for each inpatient unit (n=8) as HH events per patient-hour, and for outpatient units (n=5) and the emergency room (ER) as HH events per patient-visit.  Additionally, a HH compliance index (HHCI) of actual/expected HH events was calculated after adjusting for unit type, patient census, and nurse staffing ratios. HH was monitored during the 6-month baseline period and 3-month roll-out period during which focus groups were conducted to determine preferences for feedback frequency and format. No feedback was provided to HCWs during the baseline or roll-out period. During the 6-month intervention period, monthly feedback was provided by email to all managers, executives, and department heads using a graphical report of HH compliance.

    Results: Compared to baseline, HH rates increased in 12 of the 14 units during the intervention period.  In inpatient units, the rate of HH events improved significantly; during the baseline period, HH events ranged from 0.21 to 3.47 events per patient-hour and during the feedback period, HH events ranged from 0.22 to 3.98  events per patient-hour (mean difference=0.17 events/patient hour, SD=0.15, p=0.008). In outpatient units and the ER, the rate of HH events did not change significantly (mean difference=0.40 events/patient visit, SD=0.83, p=0.29). Overall, the HHCI for the 5 medical-surgical units, CCU and ER combined was significantly higher after the feedback compared to before (mean difference=4.9% compliance, SD 4.3, p=0.02).

    Conclusion:  Implementation of an automated HH monitoring and feedback system was associated with improved HH compliance in inpatient units. This innovative technology merits further testing in controlled multicenter trials.

    Laurie Conway, RN, MPhil, CIC1, Linda Riley, RN, MEd, CIC2, Bevin Cohen, MPH3, Lisa Saiman, MD, MPH, FSHEA4, Paul Alper, BA5 and Elaine Larson, PhD, RN, FIDSA, FSHEA3, (1)Columbia University School of Nursing, New York, NY, (2)Infection Prevention, Cooley Dickinson Hospital, Northampton, MA, (3)School of Nursing, Columbia University Medical Center, New York, NY, (4)Columbia University College of Physicians & Surgeons, New York, NY, (5)Deb Worldwide Healthcare, Inc., Charlotte, NC


    L. Conway, Deb Worldwide Healthcare Inc.: Investigator, Research support

    L. Riley, Deb Worldwide Healthcare: Collaborator, Research support

    B. Cohen, Deb Worldwide Healthcare Inc.: Investigator, Research support

    L. Saiman, Deb Worldwide Healthcare Inc.: Grant Investigator, Research grant

    P. Alper, Deb Worldwide Healthcare Inc.: Employee, Salary

    E. Larson, Deb Worldwide Healthcare Inc.: Grant Investigator, Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.