1096. Validation of an aggregate electronic monitoring system for hand hygiene
Session: Poster Abstract Session: Infection Prevention: Hand Hygiene and PPE
Friday, October 9, 2015
Room: Poster Hall
  • IDWeek_Validation poster.pdf (223.5 kB)
  • Background: Direct observation of hand hygiene behavior captures less than 1% of all HH opportunities, making this method highly unreliable. Despite a number of new electronic monitoring systems (EMS) on the market, less than 20% of studies referencing these systems refer to any validation process to ensure measurement accuracy. Our team set out to validate the GoJo Smartlink EMS.

    Methods: First, each activity counter (placed above each patient room doorway) and dispenser actuation counter (placed in every soap and alcohol-bassed rub dispenser) was tested for basic functionality, Next, a planned path was followed, systematically activating every activity counter and dispenser actuation counter. This activity recorded by an observer to ensure documentation of any deviations from the planned path and compared to electronic data captured by the GoJo electronic monitoring system. Any deviations were counted against the system as ‘inaccurate.’ Inaccuracies were reported to the GoJo team, who worked with infection control (IC) to reposition activity counters and ensure functionality of the system. Upon reaching 90% accuracy with purposeful system activation by IC, over 100 hours of observations were conducted to determine accuracy of the EMS in capturing routine healthcare worker (HCW) behavior. Direct observation of room activity and soap or alcohol based hand rub (ABHR) use was recorded by a trained observer and again compared to raw data captured by the GoJo system. 

    Results:  Purposeful movement in and out of patient rooms was accurately captured >90% of the time, while routine HCW behavior is accurately captured by the system >85% of the time. Actuation of soap or ABHR dispensers is captured nearly 100% of the time. A majority of inaccuracy was explained by limits of the system in detecting directionality of movement: an “entry” or “exit” is labeled based upon the order in which two thermal heat detection zones are activated. Thus, routine behavior may result in activation of these zones in a reverse order- resulting in a true room entry being recorded as a room exit

    Conclusion: The team will work with frontline staff to develop Standard Work that aligns with improving HH policy, focusing on removal of unnecessary patient room activity identified during non-standardized cleaning of rooms and fetching of hospital supplies by nurses.

    Heather Limper, MPH, Clinical Effectiveness, University of Chicago Medicine, Chicago, IL, Sean Carino, MPH, Infection Control, University of Chicago Medicine, Chicago, IL, Sylvia Garcia-Houchins, RN, MBA, CIC, FSHEA, University of Chicago Medicine, Chicago, IL and Emily Landon Mawdsley, MD, Medicine, Infectious Diseases and Global Health, University of Chicago Medical Center, Chicago, IL


    H. Limper, None

    S. Carino, None

    S. Garcia-Houchins, None

    E. Landon Mawdsley, GoJo: Consultant , Speaker honorarium
    Proventix: Consultant , Speaker honorarium

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.