HANDWASHING
Driving improvement in hand hygiene
A growing body of evidence suggests that technology has an important role to play in monitoring hand hygiene performance, resulting in dramatic increases in compliance.
Contaminated healthcare workers’ hands continue to play a major role in transmitting healthcare-associated infections (HCAIs). Various studies continue to show ‘disappointing adherence rates’ – generally less than 50%, ranging from the low teens to occasional reports of over 80% in very select cohorts. Given that healthcare workers’ hands remain a main source of transmission, it follows that a major aspect of preventative efforts to reduce HCAIs should be directed towards improving hand hygiene practices among healthcare workers. Hand hygiene compliance can be
measured using various methods – including direct observation; remote observations involving video monitors; indirect calculations based on soap or alcohol product use; individual staff member product use; surveys and self- reporting; automated monitoring technologies, such as RFID (radio
‘There is a growing body of evidence emerging to suggest that the impact of compliance technologies can be dramatic.’
frequency identification); and technologies used to identify contamination, such as Adenosine Triphosphate (ATP). A recent report published by Frost &
Sullivan (Hand Hygiene Champions the Cause of Infection Control),1
predicts that
the healthcare sector will see increasing growth in demand for technology-based systems to ensure compliance. The report states: “The integration of hand hygiene compliance monitoring technologies, with the use of automated and manual
dispensers in the next five to seven years, will aid market growth as the value of infection prevention is increasingly being recognised by government and hospital management authorities.”1
Electronic hand hygiene monitoring The report follows news from Ecolab that the company has entered into a strategic alliance with Proventix Systems to use the nGage RFID system to automate hand hygiene compliance monitoring. The technology, based around an RFID tag system, worn by healthcare workers, integrates with Ecolab’s hand hygiene products and dispensers to provide real- time data about hand hygiene compliance. While manufacturers of hand hygiene
dispensers are recognising potential growth opportunities for integrated hand hygiene solutions, there is also a growing body of evidence emerging from the US to suggest that the impact of compliance technologies can be dramatic – pointing the way forward for UK healthcare organisations seeking to reduce HCAIs. A pilot project using nGage, at Princeton Baptist Medical Center in Birmingham, Alabama, showed a 22% reduction in HCAIs, following the introduction of compliance technology, for example. Lennox Archibald, a hospital
epidemiologist from the division of infectious diseases, at the College of Medicine, University of Florida, points out that direct observation of hand hygiene compliance can be very labour intensive, while data can be biased. He believes that a system that both monitors compliance and also gives a prompt to healthcare workers provides the most effective approach. At the Annual Society for Healthcare
Epidemiology of America (SHEA) Conference, he reported on the results of a study, which showed a significant reduction in infections at a paediatric hospital, based in the US, following the introduction of an electronic hand
34 THE CLINICAL SERVICES JOURNAL MARCH 2012
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