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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, 3755 Chem. de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1E2
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  • Hui Yin
    Affiliations
    Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Chem. de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1E2
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  • Fares Ould-Brahim
    Affiliations
    McGill University Faculty of Medicine, 3605 Rue de la Montagne, Montréal, QC, Canada, H3G 2M1
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  • Mona Abou Sader
    Affiliations
    Jewish General Hospital Sir Mortimer B. Davis, 3755 Chem. de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1E2
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  • Yves Longtin
    Correspondence
    Corresponding author: Dr. Yves Longtin, Jewish General Hospital - SMBD, 3755 Chemin de la Côte-Sainte-Catherine, Montréal (Québec), Canada H3T 1E2. Tel: +1 (514) 340.8294 ext 23731; Fax: +1 (514) 340-7546.
    Affiliations
    Jewish General Hospital Sir Mortimer B. Davis, 3755 Chem. de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1E2

    Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Chem. de la Côte-Sainte-Catherine, Montréal, QC, Canada, H3T 1E2

    McGill University Faculty of Medicine, 3605 Rue de la Montagne, Montréal, QC, Canada, H3G 2M1
    Search for articles by this author
  • 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 10/54 (19%) nurses, the median HH percentile rank of the rooms to which they were assigned was higher than the group average (p<0.001; range of percentiles, 64th to 85th). A lower median percentile was seen in 9/54 (17%) participants (p<0.001; range of percentiles, 22nd to 39th). The negative binomial model confirmed this association and identified 15/54 high performers (range of adjusted incidence rate ratios [aIRR], 1.17-1.83) and 16/54 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.

      Keywords

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