In the world of healthcare superbugs, methicillin-resistant Staphylococcus aureus (MRSA) is a celebrity. It is resistant to many antibiotics and is 2.5 times more lethal than infections treatable with methicillin. MRSA can be found anywhere in a hospital setting – from ICUs to the OR – and is most often transferred on hands. More than 126,000 hospitalized patients get MRSA infections annually, and the IHI estimates that more than 5,000 patients die each year as a result.
Nip it in the bud with clean hands
Now in press, a first-of-its-kind study , a first-of-its-kind study in the American Journal of Infection Control has shown that improving hand hygiene compliance has a direct impact on the rate of MRSA infections in a hospital.
The study, “Electronic Hand Hygiene Monitoring as a Tool for Reducing Healthcare-Associated Methicillin-resistant Staphylococcus aureus Infection,” shows a direct correlation between the implementation of an electronic hand hygiene monitoring technology based on World Health Organization’s Five Moments for Hand Hygiene and a decrease in the incidence of hospital onset MRSA infections. Some of the key findings – both statistically significant - include:
- Hand hygiene compliance rates increased by 25.5 percent.
- Hospital onset MRSA HAI rates decreased by 42 percent. This represents 24 MRSA infections that were prevented during that time period.
Watch what you measure –5 moments are better than 2
Of particular importance in the study is that clinical staff were trained to perform hand hygiene based on the WHO Five Moments for Hand Hygiene guidelines, and the electronic system used to monitor and evaluate performance also measured hand hygiene opportunities based on the Five Moments.
When it comes to hand hygiene the “in and out”, or 2 moments-method is the one most healthcare facilities are using across North America. Sadly, it is widely known that this method of cleaning hands, only when entering and exiting a patient room, has been found to miss as much as 50 percent of all hand hygiene opportunities, potentially putting patients at risk of contracting an infection.
Real data, real results
This study on electronic hand hygiene monitoring and MRSA was conducted between July, 2012 and March, 2015 in 23 inpatient units. Data on hand hygiene compliance rates (representing over 20 million hand hygiene events) from the DebMed electronic monitoring reports were provided to unit leadership and frontline staff at Greenville Health System in Greenville, SC.
The accurate, reliable data enabled the leadership to provide actionable feedback to clinical staff to drive behavior change that resulted in increased hand hygiene compliance and decreased infection rates.
This study is significant not only for DebMed, but the entire infection prevention community because it is the first of its kind to show a statistically significant relationship between the use of the WHO 5 Moments, data from an electronic monitoring system and reduced MRSA HAIs. In seeing the compelling results from the study our next questions should be, is hand hygiene at the “in and out” or two moment method still an acceptable practice? With proof of hospital-onset MRSA HAI rates decreasing by 42 percent, is that motivation enough to implement a system that can accurately measure by the higher standard of the WHO 5 Moments? We think so.