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Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | Research article

Comparison of two electronic hand hygiene monitoring systems in promoting hand hygiene of healthcare workers in the intensive care unit

Authors: Xiao Zhong, Dong-Li Wang, Li-Hua Xiao, Lan-Fang Mo, Qing-Fei Wu, Yan-Wei Chen, Xiao-Feng Luo

Published in: BMC Infectious Diseases | Issue 1/2021

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Abstract

Background

Hand hygiene (HH) is the cornerstone of infection control, and the promotion of HH is the focus of the world. The study aims to compare the role of two different types of electronic hand hygiene monitoring systems (EHHMSs) in promoting HH of healthcare workers (HCWs) in the intensive care unit (ICU).

Methods

In a 16-bed ICU of a general tertiary hospital in Shenzhen, the research was divided into three stages with interrupted time series (ITS) design. In the first stage, the direct observation method was used to monitor and feed back the HH compliance rate of HCWs monthly. In the second stage, the type1 EHHMS was applied to monitor and feed back the individual number of HH events monthly. In the third stage, the type2 EHHMS with a function of instant reminder and feedback was employed, and the personal HH compliance rates were fed back monthly. Meanwhile, direct observation continued in the last two stages.

Results

In the second stage, The HH compliance rate increased. However, there was no significant difference in the trajectory of the rate compared with the first stage. In the first month of the third stage, the HH compliance rate increased by 12.324% immediately and then ascended by 1.242% over time. The number of HH events per bed day and HH products’ consumption per bed day were consistent with the change of HH compliance rate observed.

Conclusion

Monitoring and feedback can improve the HH of HCWs. The EHHMS, with the function of real-time reminders and feedback, has a more noticeable effect on promoting HH.
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Literature
1.
go back to reference Stella SA, Stace RJ, Knepper BC, Reese SM, Keniston A, Burden M, Young HL. The effect of eye images and a social norms message on healthcare provider hand hygiene adherence. Infect Control Hosp Epidemiol. 2019;40(7):748–54.PubMedCrossRef Stella SA, Stace RJ, Knepper BC, Reese SM, Keniston A, Burden M, Young HL. The effect of eye images and a social norms message on healthcare provider hand hygiene adherence. Infect Control Hosp Epidemiol. 2019;40(7):748–54.PubMedCrossRef
2.
go back to reference Pittet D, Allegranzi B, Sax H, Dharan S, Pessoa-Silva CL, Donaldson L, Boyce JM. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis. 2006;6(10):641–52.PubMedCrossRef Pittet D, Allegranzi B, Sax H, Dharan S, Pessoa-Silva CL, Donaldson L, Boyce JM. Evidence-based model for hand transmission during patient care and the role of improved practices. Lancet Infect Dis. 2006;6(10):641–52.PubMedCrossRef
3.
go back to reference Boyce JM, Polgreen PM, Monsalve M, Macinga DR, Arbogast JW. Frequency of use of alcohol-based hand rubs by nurses: a systematic review. Infect Control Hosp Epidemiol. 2017;38(2):189–95.PubMedCrossRef Boyce JM, Polgreen PM, Monsalve M, Macinga DR, Arbogast JW. Frequency of use of alcohol-based hand rubs by nurses: a systematic review. Infect Control Hosp Epidemiol. 2017;38(2):189–95.PubMedCrossRef
4.
go back to reference Organization WH, Safety WP. WHO guidelines on hand hygiene in health care. Geneva: World Health Organization; 2009. Organization WH, Safety WP. WHO guidelines on hand hygiene in health care. Geneva: World Health Organization; 2009.
5.
go back to reference Grayson ML, Stewardson AJ, Russo PL, Ryan KE, Olsen KL, Havers SM, Greig S, Cruickshank M. Hand hygiene a, the National Hand Hygiene I: effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, healthcare worker education, and clinical outcomes: a longitudinal study. Lancet Infect Dis. 2018;18(11):1269–77.PubMedCrossRef Grayson ML, Stewardson AJ, Russo PL, Ryan KE, Olsen KL, Havers SM, Greig S, Cruickshank M. Hand hygiene a, the National Hand Hygiene I: effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, healthcare worker education, and clinical outcomes: a longitudinal study. Lancet Infect Dis. 2018;18(11):1269–77.PubMedCrossRef
6.
go back to reference Barnes SL, Morgan DJ, Harris AD, Carling PC, Thom KA. Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions. Infect Control Hosp Epidemiol. 2014;35(9):1156–62.PubMedPubMedCentralCrossRef Barnes SL, Morgan DJ, Harris AD, Carling PC, Thom KA. Preventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions. Infect Control Hosp Epidemiol. 2014;35(9):1156–62.PubMedPubMedCentralCrossRef
7.
go back to reference Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 2010;31(3):283–94.PubMedCrossRef Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol. 2010;31(3):283–94.PubMedCrossRef
8.
go back to reference Neo JR, Sagha-Zadeh R, Vielemeyer O, Franklin E. Evidence-based practices to increase hand hygiene compliance in health care facilities: an integrated review. Am J Infect Control. 2016;44(6):691–704.PubMedCrossRef Neo JR, Sagha-Zadeh R, Vielemeyer O, Franklin E. Evidence-based practices to increase hand hygiene compliance in health care facilities: an integrated review. Am J Infect Control. 2016;44(6):691–704.PubMedCrossRef
9.
go back to reference Price L, MacDonald J, Gozdzielewska L, Howe T, Flowers P, Shepherd L, Watt Y, Reilly J. Interventions to improve healthcare workers' hand hygiene compliance: a systematic review of systematic reviews. Infect Control Hosp Epidemiol. 2018;39(12):1449–56.PubMedCrossRef Price L, MacDonald J, Gozdzielewska L, Howe T, Flowers P, Shepherd L, Watt Y, Reilly J. Interventions to improve healthcare workers' hand hygiene compliance: a systematic review of systematic reviews. Infect Control Hosp Epidemiol. 2018;39(12):1449–56.PubMedCrossRef
10.
go back to reference Alshehari AA, Park S, Rashid H. Strategies to improve hand hygiene compliance among healthcare workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152–8.PubMedCrossRef Alshehari AA, Park S, Rashid H. Strategies to improve hand hygiene compliance among healthcare workers in adult intensive care units: a mini systematic review. J Hosp Infect. 2018;100(2):152–8.PubMedCrossRef
11.
go back to reference Jeanes A, Coen PG, Drey NS, Gould DJ. Moving beyond hand hygiene monitoring as a marker of infection prevention performance: development of a tailored infection control continuous quality improvement tool. Am J Infect Control. 2020;48(1):68–76.PubMedCrossRef Jeanes A, Coen PG, Drey NS, Gould DJ. Moving beyond hand hygiene monitoring as a marker of infection prevention performance: development of a tailored infection control continuous quality improvement tool. Am J Infect Control. 2020;48(1):68–76.PubMedCrossRef
12.
go back to reference Edmisten C, Hall C, Kernizan L, Korwek K, Preston A, Rhoades E, Shah S, Spight L, Stradi S, Wellman S, et al. Implementing an electronic hand hygiene monitoring system: lessons learned from community hospitals. Am J Infect Control. 2017;45(8):860–5.PubMedCrossRef Edmisten C, Hall C, Kernizan L, Korwek K, Preston A, Rhoades E, Shah S, Spight L, Stradi S, Wellman S, et al. Implementing an electronic hand hygiene monitoring system: lessons learned from community hospitals. Am J Infect Control. 2017;45(8):860–5.PubMedCrossRef
13.
go back to reference Doll ME, Masroor N, Cooper K, Trimmer T, Pryor R, Auricchio J, Armstrong-Novak JD, Stevens MP, Bearman G. A comparison of the accuracy of two electronic hand hygiene monitoring systems. Infect Control Hosp Epidemiol. 2019;40(10):1194–7.PubMedCrossRef Doll ME, Masroor N, Cooper K, Trimmer T, Pryor R, Auricchio J, Armstrong-Novak JD, Stevens MP, Bearman G. A comparison of the accuracy of two electronic hand hygiene monitoring systems. Infect Control Hosp Epidemiol. 2019;40(10):1194–7.PubMedCrossRef
14.
go back to reference Marra AR, Edmond MB. New technologies to monitor healthcare worker hand hygiene. Clin Microbiol Infect. 2014;20(1):29–33.PubMedCrossRef Marra AR, Edmond MB. New technologies to monitor healthcare worker hand hygiene. Clin Microbiol Infect. 2014;20(1):29–33.PubMedCrossRef
15.
go back to reference Storey SJ, FitzGerald G, Moore G, Knights E, Atkinson S, Smith S, Freeman O, Cryer P, Wilson AP. Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance. J Hosp Infect. 2014;88(2):84–8.PubMedCrossRef Storey SJ, FitzGerald G, Moore G, Knights E, Atkinson S, Smith S, Freeman O, Cryer P, Wilson AP. Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance. J Hosp Infect. 2014;88(2):84–8.PubMedCrossRef
16.
go back to reference Ward MA, Schweizer ML, Polgreen PM, Gupta K, Reisinger HS, Perencevich EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. Am J Infect Control. 2014;42(5):472–8.PubMedCrossRef Ward MA, Schweizer ML, Polgreen PM, Gupta K, Reisinger HS, Perencevich EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. Am J Infect Control. 2014;42(5):472–8.PubMedCrossRef
17.
go back to reference Pong S, Holliday P, Fernie G. Effect of electronic real-time prompting on hand hygiene behaviors in health care workers. Am J Infect Control. 2018;46(7):768–74.PubMedCrossRef Pong S, Holliday P, Fernie G. Effect of electronic real-time prompting on hand hygiene behaviors in health care workers. Am J Infect Control. 2018;46(7):768–74.PubMedCrossRef
18.
go back to reference Wiemken TL, Hainaut L, Bodenschatz H, Varghese R. Hand hygiene compliance surveillance with time series anomaly detection. Am J Infect Control. 2019;47(12):1449–52.PubMedCrossRef Wiemken TL, Hainaut L, Bodenschatz H, Varghese R. Hand hygiene compliance surveillance with time series anomaly detection. Am J Infect Control. 2019;47(12):1449–52.PubMedCrossRef
19.
go back to reference Luangasanatip N, Hongsuwan M, Limmathurotsakul D, Lubell Y, Lee AS, Harbarth S, Day NPJ, Graves N, Cooper BS: Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ (Clinical research ed). 2015. Luangasanatip N, Hongsuwan M, Limmathurotsakul D, Lubell Y, Lee AS, Harbarth S, Day NPJ, Graves N, Cooper BS: Comparative efficacy of interventions to promote hand hygiene in hospital: systematic review and network meta-analysis. BMJ (Clinical research ed). 2015.
20.
go back to reference Armellino D, Hussain E, Schilling ME, Senicola W, Eichorn A, Dlugacz Y, Farber BF. Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis. 2012;54(1):1–7.PubMedCrossRef Armellino D, Hussain E, Schilling ME, Senicola W, Eichorn A, Dlugacz Y, Farber BF. Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clin Infect Dis. 2012;54(1):1–7.PubMedCrossRef
21.
go back to reference Fisher DA, Seetoh T, Oh May-Lin H, Viswanathan S, Toh Y, Yin WC, Siw Eng L, Yang TS, Schiefen S, Je M, et al. Automated measures of hand hygiene compliance among healthcare workers using ultrasound: validation and a randomized controlled trial. Infect Control Hosp Epidemiol. 2013;34(9):919–28.PubMedCrossRef Fisher DA, Seetoh T, Oh May-Lin H, Viswanathan S, Toh Y, Yin WC, Siw Eng L, Yang TS, Schiefen S, Je M, et al. Automated measures of hand hygiene compliance among healthcare workers using ultrasound: validation and a randomized controlled trial. Infect Control Hosp Epidemiol. 2013;34(9):919–28.PubMedCrossRef
22.
go back to reference Boscart VM, McGilton KS, Levchenko A, Hufton G, Holliday P, Fernie GR. Acceptability of a wearable hand hygiene device with monitoring capabilities. J Hosp Infect. 2008;70(3):216–22.PubMedCrossRef Boscart VM, McGilton KS, Levchenko A, Hufton G, Holliday P, Fernie GR. Acceptability of a wearable hand hygiene device with monitoring capabilities. J Hosp Infect. 2008;70(3):216–22.PubMedCrossRef
23.
24.
go back to reference McKay KJ, Shaban RZ, Ferguson P. Hand hygiene compliance monitoring: do video-based technologies offer opportunities for the future? Infect Dis Health. 2020. McKay KJ, Shaban RZ, Ferguson P. Hand hygiene compliance monitoring: do video-based technologies offer opportunities for the future? Infect Dis Health. 2020.
25.
go back to reference Vaisman A, Bannerman G, Matelski J, Tinckam K, Hota SS. Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events. BMJ Qual Saf. 2020;29(11): bmjqs-2019-010310. Vaisman A, Bannerman G, Matelski J, Tinckam K, Hota SS. Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events. BMJ Qual Saf. 2020;29(11): bmjqs-2019-010310.
26.
go back to reference Levin PD, Razon R, Schwartz C, Avidan A, Sprung CL, Moses AE, Benenson S. Obstacles to the successful introduction of an electronic hand hygiene monitoring system, a cohort observational study. Antimicrob Resist Infect Control. 2019;8:43.PubMedPubMedCentralCrossRef Levin PD, Razon R, Schwartz C, Avidan A, Sprung CL, Moses AE, Benenson S. Obstacles to the successful introduction of an electronic hand hygiene monitoring system, a cohort observational study. Antimicrob Resist Infect Control. 2019;8:43.PubMedPubMedCentralCrossRef
27.
go back to reference Swoboda SM, Earsing K, Strauss K, Lane S, Lipsett PA. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit. Crit Care Med. 2004;32(2):358–63.PubMedCrossRef Swoboda SM, Earsing K, Strauss K, Lane S, Lipsett PA. Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit. Crit Care Med. 2004;32(2):358–63.PubMedCrossRef
28.
go back to reference Al Salman JM, Hani S, de Marcellis-Warin N, Isa SF. Effectiveness of an electronic hand hygiene monitoring system on healthcare workers' compliance to guidelines. J Infect Public Health. 2015;8(2):117–26.PubMedCrossRef Al Salman JM, Hani S, de Marcellis-Warin N, Isa SF. Effectiveness of an electronic hand hygiene monitoring system on healthcare workers' compliance to guidelines. J Infect Public Health. 2015;8(2):117–26.PubMedCrossRef
29.
go back to reference Masroor N, Doll M, Stevens M, Bearman G. Approaches to hand hygiene monitoring: from low to high technology approaches. Int J Infect Dis. 2017;65:101–4.PubMedCrossRef Masroor N, Doll M, Stevens M, Bearman G. Approaches to hand hygiene monitoring: from low to high technology approaches. Int J Infect Dis. 2017;65:101–4.PubMedCrossRef
30.
go back to reference Lebovic G, Siddiqui N, Muller MP. Predictors of hand hygiene compliance in the era of alcohol-based hand rinse. J Hosp Infect. 2013;83(4):276–83.PubMedCrossRef Lebovic G, Siddiqui N, Muller MP. Predictors of hand hygiene compliance in the era of alcohol-based hand rinse. J Hosp Infect. 2013;83(4):276–83.PubMedCrossRef
31.
go back to reference Boscart VM, Levchenko AI, Fernie GR. Defining the configuration of a hand hygiene monitoring system. Am J Infect Control. 2010;38(7):518–22.PubMedCrossRef Boscart VM, Levchenko AI, Fernie GR. Defining the configuration of a hand hygiene monitoring system. Am J Infect Control. 2010;38(7):518–22.PubMedCrossRef
32.
go back to reference Cheng VC, Tai JW, Ho SK, Chan JF, Hung KN, Ho PL, Yuen KY. Introduction of an electronic monitoring system for monitoring compliance with moments 1 and 4 of the WHO “my 5 moments for hand hygiene” methodology. BMC Infect Dis. 2011;11:151.PubMedPubMedCentralCrossRef Cheng VC, Tai JW, Ho SK, Chan JF, Hung KN, Ho PL, Yuen KY. Introduction of an electronic monitoring system for monitoring compliance with moments 1 and 4 of the WHO “my 5 moments for hand hygiene” methodology. BMC Infect Dis. 2011;11:151.PubMedPubMedCentralCrossRef
33.
go back to reference Conway LJ. Challenges in implementing electronic hand hygiene monitoring systems. Am J Infect Control. 2016;44(5 Suppl):e7–e12.PubMedCrossRef Conway LJ. Challenges in implementing electronic hand hygiene monitoring systems. Am J Infect Control. 2016;44(5 Suppl):e7–e12.PubMedCrossRef
Metadata
Title
Comparison of two electronic hand hygiene monitoring systems in promoting hand hygiene of healthcare workers in the intensive care unit
Authors
Xiao Zhong
Dong-Li Wang
Li-Hua Xiao
Lan-Fang Mo
Qing-Fei Wu
Yan-Wei Chen
Xiao-Feng Luo
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05748-3

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