scholarly journals Electronic hand hygiene monitoring systems can be well-tolerated by health workers: Findings of a qualitative study

2021 ◽  
pp. 175717742110127
Author(s):  
D Kelly ◽  
E Purssell ◽  
N Wigglesworth ◽  
DJ Gould
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Electronic Monitoring ◽  
Health Workers ◽  
Qualitative Interviews ◽  
Poor Performance ◽  
Frontline Health Workers ◽  
National Health Service Trust ◽  
Personal Accountability ◽  
The Uk

Background: Electronic hand hygiene monitoring overcomes limitations associated with manual audit but acceptability to health workers varies and may depend on culture of the ward and the nature of the system. Objectives: Evaluate the acceptability of a new fifth type electronic monitoring system to frontline health workers in a National Health Service trust in the UK. Methods: Qualitative interviews with 11 informants following 12 months experience using an electronic monitoring system. Results: Informants recognised the importance of hand hygiene and embraced technology to improve adherence. Barriers to hand hygiene adherence included heavy workload, dealing with emergencies and ergonomic factors related to placement of alcohol dispensers. Opinions about the validity of the automated readings were conflicting. Some health workers thought they were accurate. Others reported problems associated with differences in the intelligence of the system and their own clinical decisions. Opinions about feedback were diverse. Some health workers thought the system increased personal accountability for hand hygiene. Others ignored feedback on suboptimal performance or ignored the data altogether. It was hard for health workers to understand why the system registered some instances of poor performance because feedback did not allow omissions in hand hygiene to be related to the context of care. Conclusion: Electronic monitoring can be very well tolerated despite some limitations. Further research needs to explore different reactions to feedback and how often clinical emergencies arise. Electronic and manual audit have complementary strengths.

scholarly journals Electronic hand hygiene monitoring: accuracy, impact on the Hawthorne effect and efficiency

2020 ◽  
Vol 21 (4) ◽  
pp. 136-143 ◽  
Author(s):  
Dinah Gould ◽  
Håkan Lindström ◽  
Edward Purssell ◽  
Neil Wigglesworth
Keyword(s):  
Hand Hygiene ◽  
Electronic Monitoring ◽  
Health Workers ◽  
Hawthorne Effect ◽  
Observation Methods ◽  
National Health Service Trust ◽  
Monitoring Accuracy ◽  
Electronic Measurement ◽  
High Level ◽  
Continuous Movements

Objectives: To evaluate a type five electronic monitoring system (EMS) for hand hygiene (HH) adherence with respect to accuracy and ability to avoid the Hawthorne effect. Design: HH events were observed manually and electronically. The agreement between the two observation methods was evaluated. Continuous electronic measurement was made throughout the study. Setting: An acute 31-bed medical ward in a National Health Service trust in London, United Kingdom. Participants: Staff working or attached to the ward. Intervention: A newly developed type five EMS that can measure disinfectant dispenser usage as well as continuous movements of health workers throughout the ward with arm-length precision and analyse HH adherence was installed at the ward. Results: A total of 294 HH events were observed in five sessions by an observer previously unknown to the ward. There was concordance between HH adherence assessed by manual observer and the EMS on 84% (79.1%–89.9%) of the occasions. During the five observation sessions, the observed HH adherence increased from 24% to 76% while the EMS measurements immediately before the arrival of the observer remained constant for all sessions. Conclusion: The 84% agreement between the EMS and the manual observation suggest a high level of precision for the evaluated system. The Hawthorne effect (higher rate of HH performance) was clearly seen in the increase by a factor of three in the manually observed adherence from session to session as the health workers became more aware of them being observed. The EMS was able to avoid the Hawthorne effect when the observer was not present.

Use of an Electronic Monitoring System to Determine Hand Hygiene Patterns for both Staff and Equipment

2011 ◽  
Vol 39 (5) ◽  
pp. E166 ◽  
Author(s):  
Carmen Ventrucci ◽  
Cindy L. Bryant ◽  
Cheryl A. Littau ◽  
Victor Morin
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Electronic Monitoring

scholarly journals Validation of an Aggregate Electronic Monitoring System for Hand Hygiene

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Heather Limper ◽  
Sean Carino ◽  
Sylvia Garcia-Houchins ◽  
Emily Landon Mawdsley
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Electronic Monitoring

scholarly journals Large-Scale Analysis of Hand Hygiene Frequency Across Healthcare Facilities Varying in Key Hospital Characteristics

2020 ◽  
Vol 41 (S1) ◽  
pp. s448-s448
Author(s):  
Jessica Albright ◽  
Bruce White ◽  
Pete Carlson ◽  
Cheryl Littau
Keyword(s):  
Hand Hygiene ◽  
Healthcare Worker ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Small Sample ◽  
Healthcare Facilities ◽  
Hygiene Practices ◽  
Area Classification ◽  
Hospital Characteristics

Background: Hand hygiene by healthcare personnel is a critical infection prevention intervention. Direct observation, the most widely utilized method to observe hand hygiene practices, often provides an incomplete picture due to small sample size and altered behavior in the presence of observers. A growing number of healthcare facilities are employing electronic hand hygiene monitoring systems to capture overall compliance rates. These electronic systems can provide a wealth of data on hand hygiene practices within and across healthcare facilities. Objective: We used high-accuracy electronic monitoring data to perform a detailed analysis of hand hygiene practices across numerous facilities that varied in key hospital characteristics. Methods: In total, 11 tertiary-care facilities were equipped with an electronic hand hygiene monitoring system. Hospitals varied in size, region, area classification (urban vs rural), acuity level, and teaching status. The electronic monitoring system was composed of uniquely assigned employee badges and electronically monitored dispensers. Every recorded dispensing event was time stamped and associated with a specific healthcare worker, the location of the dispenser, and the specific product being dispensed (ie, alcohol-based hand rub [ABHR] or hand soap). The total number of dispensing events for each product type and the total number of hours worked were calculated for each healthcare worker and were used to determine hand hygiene frequency. Hospital attributes, such as size and area classification, were obtained from publicly available sources including but not limited to facility-owned websites and CMS data. Results: More than 15.7 million hand hygiene events, performed by nearly 11,000 healthcare workers, were captured by the electronic monitoring system and were included in the analysis. Overall, median hand hygiene frequency was 4.1 events per hour and ranged from 2.0 events per hour to 5.6 events per hour, depending on the facility. ABHR use (median, 3.6 events per hour) was more frequent than handwashing (median, 0.4 events per hour). Hospitals included in the analysis ranged from small (<20 beds) rural facilities to large (>600 beds) academic hospitals and provided a variety of services from general medical-surgical treatment to intensive care. Interfacility differences in observed hand hygiene frequency were analyzed. Conclusions: The current analysis reinforces and builds upon previous work that examined a smaller subset of 5 hospitals located in a single geographic region. Combined, these datasets represent >20 million hand hygiene events among ∼15,000 healthcare workers from 16 unique healthcare facilities. This analysis provides detailed information about hand hygiene practices across a diverse set of healthcare facilities.Funding: Ecolab, Inc, provided support for this study.Disclosures: Jessica Carol Albright and Cheryl A Littau report salary from Ecolab.

scholarly journals Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Vincent CC Cheng ◽  
Josepha WM Tai ◽  
Sara KY Ho ◽  
Jasper FW Chan ◽  
Kwan Ngai Hung ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Electronic Monitoring

scholarly journals 1187. Estimation of Individual Healthcare Workers’ Relative Hand Hygiene Compliance Using an Anonymous Electronic Monitoring System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S425-S426 ◽  
Author(s):  
Maxime-Antoine Tremblay ◽  
Mona Abou Sader ◽  
Yves Longtin
Keyword(s):  
Hand Hygiene ◽  
Monitoring System ◽  
Healthcare Workers ◽  
Electronic Monitoring ◽  
Tertiary Care ◽  
Care Hospital ◽  
Z Score ◽  
Significant Difference ◽  
Z Scores ◽  
Individual Healthcare

Abstract Background The current hand hygiene (HH) auditing and feedback strategy include anonymized data collection using direct observation and feedback of aggregated data. We aimed to evaluate whether an anonymous (without wearable device) HH electronic monitoring system (EMS) could detect patterns associated with individual healthcare workers (HCWs) and estimate their relative HH performance. Methods Observational study of HH compliance via an EMS in 10 rooms in a tertiary care hospital. The EMS measures HH product dispenser activation (an indicator of HH events) as well as entries and exits from patient rooms (a surrogate of HH opportunities). HH rates were obtained by dividing the number of HH events by the number of opportunities. HH rates were aggregated at room-shift level (i.e., an 8-hour period for a single room). For each room-shift, the HH rate was converted to a Z score, which was then associated with the individual HCW assigned to that room-shift. The relative HH performance of individual HCWs was estimated by comparing the mean Z scores of each HCW with the rest of the group by the Student T-test, with a level of significance set at P < 0.001 after adjustment by Bonferroni’s correction. To investigate whether any association could be due to chance, we looked into the potential association between average Z scores and calendar days, as a counterexample. Results Over a 100-day period, there were 45 775 HH events and 136 821 opportunities (global compliance, 33%). Schedules were available for 2980 room-shifts. Fifty-four individual HCWs took part in at least one room-shift (average per HCW, 52 room-shifts; range 1–140). Eight HCWs (15%) had a mean Z score significantly above the group average (Figure 1, green boxes; mean Z score 0.71; range, 0.52 to 0.86; P < 0.001), whereas 9 HCWs (17%) had a significantly inferior Z score (Figure 1, red boxes; mean Z score -0.47, range -0.58 to -0.31, P < 0.001). In contrast, there was no significant difference in Z scores between calendar days (Figure 2; p >0.001). Conclusion Cross-linking a high-volume HH database with HCW schedules identified a significant association between individual HCWs and HH compliance in the rooms to which they were assigned. If confirmed in further studies, anonymous EMS could be used to provide HCWs with personalized relative HH compliance feedback. Disclosures All authors: No reported disclosures.

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