This is the last of a five-part series that covered best practices for driving hand hygiene compliance. This blog zeroes in on the role of accurate automated monitoring and feedback to achieve optimal compliance.
From influenza to methicillin-resistant Staphylococcus aureus (MRSA) and other antimicrobial-resistant pathogens, there are a wide range of microbes that may be transferred via improper hand hygiene. Recently researchers in Queensland, Australia (Queensland University of Technology and the University of Queensland), while developing techniques for studying the longevity of airborne bacteria, determined that some common disease-causing pathogens can spread up to 4m and remain alive in the air for up to 45 minutes.1
The critical role of contact transfer in hospital-acquired infections (HAIs), which affect thousands of patients each year, is not in dispute. Nor is there much doubt about the vital need to break the chain of transmission via healthcare worker’s hands. What is being debated today is how best to empower healthcare professionals to improve their hand hygiene performance, to improve compliance and reduce infections among vulnerable patients. Implementation of an electronic hand hygiene compliance monitoring system, along with use of objective data measuring staff performance on WHO 5 Moments compliance, at a 647-bed teaching hospital in South Carolina, led to a 25.5% improvement in hand hygiene compliance, a 42.8% reduction in hospital onset MRSA infections, and cost avoidance of over $433,000.
As hospitals are looking for methods of tracking hand hygiene compliance that are cost-effective, easy to implement and readily accepted by staff, here are a few points to keep in mind.
- The Eyes Don’t Have It. Direct observation of hand hygiene compliance has been proven to be unreliable through multiple studies due largely to theHawthorne effect, which typically inflates compliance numbers significantly.
- Go With the Flow. Some hospitals have observed significant increases in hand hygiene compliance when hand hygiene is integrated into the clinical workflow, as recommended in the World Health Organization’s (WHO)5 Moments for Hand Hygiene Compliance. The ideal hand hygiene compliance system records, measures, and reports hand hygiene behavior without disrupting or changing the clinical workflow. The bottom line: Hand hygiene works best in the context of caring for patients.
- After the Data Deluge. Professionals on the front lines of patientcare want accurate, timely, evidence-based data that allows them to make better, more informed decisions. Such data lets them know where they stand on hand hygiene performance. How are various units performing? Is compliance higher on weekdays or weekends? Accurate and timely data is the first step in helping healthcare professionals make a decision on how, when and where to change or improvehand hygiene behavior.
- On Point at the Point-of-Care. Question: Where areclinicians when they are delivering care to patients? Hand hygiene compliance is dependent upon clinicians being able to easily clean their hands at the point-of-care within the patient zone, without having to step away to access a wall-mounted dispenser.
Point-of-care hand hygiene is endorsed by WHO, CDC and the Joint Commission Center for Transforming Healthcare Lean Six Sigma Hand Hygiene Project. Look for hand hygiene monitoring systems that can monitor not just wall-mounted dispensers but also sanitizer pump bottles right at the point-of-care, including the NICU.
- It Takes a Village. While hand hygiene requires individual commitment, it’s also a team sport. Hospitals seek to build a team-based culture that supports hand hygiene compliance. This might include everything from huddles on hand hygiene data and coaching, to incentives and recognition of hand hygiene superstars.
While hand hygiene is, of course, not the only measure to counter healthcare-associated infections (HAIs), according to the World Health Organization, improving hand hygiene compliance can dramatically enhance patient safety, because there is much scientific evidence showing that improved compliance reduces risk of infection.
Learn about the DebMed Electronic Hand Hygiene Compliance Monitoring System, which is proven to be an accurate and reliable method of measuring compliance based on the WHO 5 Moments and CDC guidance.
1 Infection Control Today, June 19, 2017.