Background
Monitoring of hand hygiene is an important part of the improvement of hospital quality
indicators.
Methods
This study was prospectively performed over a 14-week (electronic observer) period
from December 3, 2013-March 9, 2014, to evaluate hand hygiene compliance in an adult
step-down unit. We compared electronic handwash counters with the application of radiofrequency
identification (RFID - ZigBee; i-Healthsys, São Carlos, Brazil) (electronic observer),
which counts each activation of the alcohol gel dispenser to direct observation (human
observer) using the iScrub application.
Results
For the overall time period of simultaneous electronic and human observation, we found
that the electronic observer identified 414 hand hygiene episodes, whereas the human
observers identified 448 episodes. Therefore, we found 92% (95% confidence interval
[CI], 90%-95%) overall concordance (414/448), with an intraclass correlation coefficient
of .87 (95% CI, 0.77-0.92).
Conclusion
Our RFID (ZigBee) system showed good accuracy (92%) and is a useful method to monitor
hand hygiene compliance.
Key Words
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References
- 2011 John M. Eisenberg Patient Safety and Quality Awards. The Henry Ford Health System No Harm Campaign: a comprehensive model to reduce harm and save lives. Innovation in patient safety and quality at the local level.Jt Comm J Qual Patient Saf. 2012; 38: 318-327
- Hand hygiene: state-of-the-art review with emphasis on new technologies and mechanisms of surveillance.Curr Infect Dis Rep. 2012; 14: 585-591
- Automated and electronically assisted hand hygiene monitoring systems: a systematic review.Am J Infect Control. 2014; 42: 472-478
- Health care infection Control practices Advisory Committee; HICPAC/SHEA/APIC/IDSA hand hygiene task force. Guideline for hand hygiene in health-care settings. Recommendations of the Health care Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.Am J Infect Control. 2002; 30: S1-S46
- Measuring rates of hand hygiene adherence in the intensive care setting: a comparative study of direct observation, product usage, and electronic counting devices.Infect Control Hosp Epidemiol. 2010; 31: 796-801
- Measurement of compliance with hand hygiene.J Hosp Infect. 2007; 66: 6-14
- Automated hand hygiene count devices may better measure compliance than human observation.Am J Infect Control. 2012; 40: 955-959
- Accuracy of a radiofrequency identification (RFID) badge system to monitor hand hygiene behavior during routine clinical activities.Am J Infect Control. 2014; 42: 144-147
- MediHandTrace®: a tool for measuring and understanding hand hygiene adherence.Clin Microbiol Infect. 2014; 20: 22-28
- Measuring hand hygiene compliance in a hematology-oncology unit: a comparative study of methodologies.Am J Infect Control. 2013; 41: 997-1000
- A mobile handheld computing application for recording hand hygiene observations.Infect Control Hosp Epidemiol. 2010; 31: 975-977
- “My five moments for hand hygiene”: a user-centred design approach to understand, train, monitor and report hand hygiene.J Hosp Infect. 2007; 67: 9-21
- The use of real-time feedback via wireless technology to improve hand hygiene compliance.Am J Infect Control. 2014; 42: 608-611
- Measuring healthcare worker hand hygiene activity: current practices and emerging technologies.Infect Control Hosp Epidemiol. 2011; 32: 1016-1028
- Automated measures of hand hygiene compliance among healthcare workers using ultrasound: validation and a randomized controlled trial.Infect Control Hosp Epidemiol. 2013; 34: 919-928
- Monitoring hand hygiene: meaningless, harmful, or helpful?.Am J Infect Control. 2013; 41: S42-S45
- Variability in the Hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units.Infect Control Hosp Epidemiol. 2009; 30: 222-225
- Estimation of hand hygiene opportunities on an adult medical ward using 24-hour camera surveillance: validation of the HOW2 Benchmarck Study.Am J Infect Control. 2014; 42: 602-607
Boyce J, Cooper T, Lunde A, Yin J, Arbogast J. Impact of an electronic hand hygiene monitoring system trial on hand hygiene compliance in a surgical intensive care unit (SICU) and general medical ward (GMW). In: San Diego, CA: ID Week 2012, Poster 37759.
Article info
Publication history
Published online: September 15, 2014
Footnotes
Financial support: This work was supported by a grant from GOJO Latin America to implement the ZigBee wireless system in the step-down unit.
Potential conflicts of interest: Marcelo Prado, Tales Roberto de Souza Santini, and Eder Issao Ishibe work for i-Healthsys. All other authors have no commercial association or financial involvement that might pose a conflict of interest in connection with this article.
Identification
Copyright
© 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
