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Investigation of individual nurses’ relative hand hygiene performance using an anonymous automated electronic hand hygiene monitoring system and a nursing assignment schedule

  • Author Footnotes
    # Current affiliation: CHU de Québec – Université Laval, 10 Rue de l'Espinay, Québec, QC, Canada, G1L 3L5.
    Maxime-Antoine Tremblay
    Footnotes
    # Current affiliation: CHU de Québec – Université Laval, 10 Rue de l'Espinay, Québec, QC, Canada, G1L 3L5.
    Affiliations
    Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada
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  • Hui Yin
    Affiliations
    Lady Davis Institute for Medical Research, Center for Clinical Epidemiology, Jewish General Hospital, Montréal, QC, Canada
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  • Fares Ould-Brahim
    Affiliations
    McGill University Faculty of Medicine Division of Infectious Diseases, 3605 Rue de la Montagne, Montréal, QC, Canada
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  • Mona Abou Sader
    Affiliations
    Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada
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  • Yves Longtin
    Correspondence
    Address correspondence to: Yves Longtin, MD Jewish General Hospital - SMBD, 3755 Chemin de la Côte-Sainte-Catherine, Montréal (Québec), Canada H3T 1E2.
    Affiliations
    Jewish General Hospital Sir Mortimer B. Davis division of infectious diseases, Montréal, QC, Canada

    Lady Davis Institute for Medical Research, Center for Clinical Epidemiology, Jewish General Hospital, Montréal, QC, Canada

    McGill University Faculty of Medicine Division of Infectious Diseases, 3605 Rue de la Montagne, Montréal, QC, Canada
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  • Author Footnotes
    # Current affiliation: CHU de Québec – Université Laval, 10 Rue de l'Espinay, Québec, QC, Canada, G1L 3L5.

      Highlights

      • Monitoring hand hygiene behavior of individual nurses is not routinely performed.
      • We tested whether an anonymous monitoring system could estimate individual behavior.
      • We found a link between a patient room's hand hygiene rate and its assigned nurse.
      • An anonymous monitoring system can estimate individual staff hand hygiene behavior.

      Abstract

      Background

      We investigated whether an anonymous automated electronic monitoring system (EMS) could be used to compare hand hygiene (HH) performance of individual nurses.

      Methods

      Prospective observational cohort study. HH performance in 10 acute-care patient rooms was estimated through an EMS that anonymously measured HH events, and room entries and exits. The association between patient room's HH compliance and the nurse in charge of each room was investigated by comparing percentile rank distributions, and through a negative binomial model.

      Results

      Over 99 days, there were 38,596 HH events and 135,546 room entries and exits (global HH performance, 28%). For 10 of 54 (19%) nurses, the median HH percentile rank of the rooms to which they were assigned was higher than the group average (P < .001; range of percentiles, 64th to 85th). A lower median percentile was seen in 9/54 (17%) participants (P < .001; range of percentiles, 22nd to 39th). The negative binomial model confirmed this association and identified 15 of 54 high performers (range of adjusted incidence rate ratios [aIRR], 1.17-1.83) and 16 of 54 low performers (range of aIRR, 0.37-0.77).

      Discussion and Conclusions

      An association exists between a room's HH rate and its assigned nurse. This association could hold potential value for an individualized feedback strategy.

      Key Words

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