Background
Hand hygiene is one of the most effective ways to prevent transmission of health care-associated
infections. Electronic systems and tools are being developed to enhance hand hygiene
compliance monitoring. Our systematic review assesses the existing evidence surrounding
the adoption and accuracy of automated systems or electronically enhanced direct observations
and also reviews the effectiveness of such systems in health care settings.
Methods
We systematically reviewed PubMed for articles published between January 1, 2000,
and March 31, 2013, containing the terms hand AND hygiene or hand AND disinfection or handwashing. Resulting articles were reviewed to determine if an electronic system was used.
Results
We identified 42 articles for inclusion. Four types of systems were identified: electronically
assisted/enhanced direct observation, video-monitored direct observation systems,
electronic dispenser counters, and automated hand hygiene monitoring networks. Fewer
than 20% of articles identified included calculations for efficiency or accuracy.
Conclusions
Limited data are currently available to recommend adoption of specific automatic or
electronically assisted hand hygiene surveillance systems. Future studies should be
undertaken that assess the accuracy, effectiveness, and cost-effectiveness of such
systems. Given the restricted clinical and infection prevention budgets of most facilities,
cost-effectiveness analysis of specific systems will be required before these systems
are widely adopted.
Key Word
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Article info
Footnotes
The work reported here was supported by the Department of Veterans Affairs (VA), Veterans Health Administration, Health Services Research and Development (HSR&D) Service through the Comprehensive Access and Delivery Research and Evaluation Center (grant No. REA 09-220). MLS is funded by a VA HSR&D Career Development Award (No. CDA 11-211). ENP was funded through a VA HSR&D grant (No. IIR 09-099). The VA Office of Research and Development had no role in the design and conduct of the study.
Conflicts of interest: None to report.
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Published by Elsevier Inc.
