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Implementing an electronic hand hygiene system improved compliance in the intensive care unit

  • Author Footnotes
    1 Qian Xu and Yang Liu contributed equally and are co-first authors.
    Qian Xu
    Footnotes
    1 Qian Xu and Yang Liu contributed equally and are co-first authors.
    Affiliations
    Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY
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  • Author Footnotes
    1 Qian Xu and Yang Liu contributed equally and are co-first authors.
    Yang Liu
    Footnotes
    1 Qian Xu and Yang Liu contributed equally and are co-first authors.
    Affiliations
    Microsensor Labs, LLC, Chicago, IL
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  • Darius Cepulis
    Affiliations
    Microsensor Labs, LLC, Chicago, IL
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  • Ann Jerde
    Affiliations
    Clinical Trials Unit, University of Louisville, Louisville, KY
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  • Rachel A. Sheppard
    Affiliations
    Clinical Trials Unit, University of Louisville, Louisville, KY
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  • Kaitlin Tretter
    Affiliations
    Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY
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  • Leah Oppy
    Affiliations
    Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY
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  • Gina Stevenson
    Affiliations
    Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY
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  • Sarah Bishop
    Affiliations
    Department of Infection Control and Prevention, University of Louisville Health, Louisville, KY
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  • Author Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    Sean P. Clifford
    Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    Affiliations
    Department of Anesthesiology & Perioperative Medicine, School of Medicine, University of Louisville, Louisville, KY
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  • Author Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    Peng Liu
    Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    Affiliations
    Microsensor Labs, LLC, Chicago, IL
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  • Author Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    ,
    Author Footnotes
    3 Maiying Kong and Jiapeng Huang contributed equally and are co-corresponding authors.
    Maiying Kong
    Correspondence
    Address correspondence to Maiying Kong, PhD, Department of Bioinformatics and Biostatistics, SPHIS, University of Louisville, Louisville, KY 40202
    Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    3 Maiying Kong and Jiapeng Huang contributed equally and are co-corresponding authors.
    Affiliations
    Microsensor Labs, LLC, Chicago, IL
    Search for articles by this author
  • Author Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    ,
    Author Footnotes
    3 Maiying Kong and Jiapeng Huang contributed equally and are co-corresponding authors.
    Jiapeng Huang
    Correspondence
    Address correspondence to Jiapeng Huang, MD, PhD, Department of Anesthesiology & Perioperative Medicine, University of Louisville, 530 South Jackson St, Louisville, KY 40202
    Footnotes
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    3 Maiying Kong and Jiapeng Huang contributed equally and are co-corresponding authors.
    Affiliations
    Department of Anesthesiology & Perioperative Medicine, School of Medicine, University of Louisville, Louisville, KY

    Department of Cardiovascular & Thoracic Surgery, School of Medicine, University of Louisville, Louisville, KY

    Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), Department of Medicine, University of Louisville, Louisville, KY

    Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY
    Search for articles by this author
  • Author Footnotes
    1 Qian Xu and Yang Liu contributed equally and are co-first authors.
    2 Sean P. Clifford, Peng Liu, Maiying Kong, and Jiapeng Huang are senior authors.
    3 Maiying Kong and Jiapeng Huang contributed equally and are co-corresponding authors.

      Highlights

      • A sensor-based electronic hand hygiene system improved hand hygiene compliance in the intensive care unit.
      • Significant variations among providers in terms of hand hygiene compliance.
      • Hand rubbing duration in partial compliance occurrences did not change significantly over time.

      Background

      Hand hygiene (HH) compliance is low and difficult to improve among health care workers. We aim to validate an electronic HH system and assess the impact of this system on HH compliance and quality changes over time at both group and individual levels.

      Methods

      An automated electronic HH system was installed in a 10-bed surgical intensive care unit.

      Results

      The full HH compliance rate increased significantly from 8.4% in week 1 to 20.5% in week 16 with week 10 being the highest (27.4%). The partial compliance rate maintained relative consistency between 13.2% and 20.0%. The combined compliance rate (full compliance rate + partial compliance rate) increased from 23.5% in week 1 to 34.6% in week 16 with week 10 being the highest (41.4%).

      Discussion

      We found significant variations among providers in terms of HH opportunities per shift, full compliance, partial compliance and combined compliance rates. The average duration of hand rubbing over time in partial compliance occurrences did not change significantly over time.

      Conclusions

      A sensor-based platform with automated HH compliance and quality monitoring, real time feedback and comprehensive individual level analysis, improved providers’ HH compliance in an intensive care unit. There were significant variations among individual providers.

      Keywords

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