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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Article info
Publication history
Published online: June 04, 2022
Footnotes
Funding/support: The EMS was provided by Gojo industries (Smartlink, Akron, OH). The remaining costs were covered as part of routine infection prevention budget at the study hospital. Gojo had no role in study design, data extraction, analysis, interpretation of data, manuscript preparation or decision to publish.
Conflicts of interest: YL reported receiving research grants from Becton Dickinson and Merck. All other authors report no conflicts of interest relevant to this article.
Preliminary results from this study were presented at ID Week 2019 (abstract number 1187).
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
