HEALTHCARE HYGIENE


and restorative creams – are available from easy-to-use dispensers. Modern equipment can be fully customised to suit an institution’s specific needs, while new technology such as BioCote prevents the spread of germs on the equipment – further increasing safety.


The provision of the right products should go hand-in-hand with proper staff education: it is crucial for staff to be educated about the importance of proper skin care in the workplace, and trained in using the right techniques. This should be an ongoing conversation, rather than a one-off event.


Monitoring plays a crucial role in assuring hand hygiene compliance in hospitals – and technology has made major advances in this field in recent times. Electronic monitoring presents hospitals with an accurate, sophisticated means to effectively monitor staff behaviour.


There is no escaping the fact that traditional measures for tracking hand hygiene compliance are outdated and ineffective. Most commonly, ‘direct observation’ is used – human observers physically monitoring staff behaviour as they perform their day to day duties and determining the healthcare facility’s compliance in line with the WHO’s ‘Five moments for hand hygiene’.


The reality is that direct observation is strewn with limitations. Observational programmes are typically conducted manually, with limited sophistication in the gathering or analysis of the data compiled – but that is just the start of the associated problems.


By being under such obvious scrutiny it is common for the ‘Hawthorne Effect’ to manifest itself, by which medical staff will be aware that they are being watched and will exhibit different behaviour to that which they would normally. As a result, compliance rates are artificially high and not a true reflection of actual hand hygiene habits.


The statistical reliability is hampered further still, quite simply because it is impossible to gather sample sizes that reflect the entire operation. Observers cannot monitor every interaction between doctors and nurses with every single patient in order to identify opportunities, and it is unrealistic to think


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non-compliance would bring, but in real terms it can be hugely damaging to staff morale, which can consequently impact their performance – feeling as though you yourself are under constant surveillance is not a desirable environment in which to work.


that observers can track every activated hand hygiene event that has taken place through keeping a watchful eye alone.


Finally, the resource needs make direct observation far from perfect. Through more efficient monitoring approaches, already strained NHS bodies can make better use of healthcare workers’ time – assigning them to other pressing tasks that are more of a reflection of their medical expertise and utilising the true value that they bring to any given establishment.


There are several monitoring options available to hospitals, but making the right decision on which to choose has a significant impact on its success – both in terms of hand hygiene compliance rates, as well as any financial implications in its installation and operating costs.


With the technological solutions now available on the market, however, there are still drawbacks that must be accounted for. Let’s take video monitoring as an example. Having 24/7 surveillance might initially seem like an appropriate choice of ‘modern’ monitoring, but it is subject to exactly the same pitfalls as traditional direct observation. Having people trawl through hours-worth of video footage from locations across a whole hospital site is costly, while being practically impossible to keep track of effectively.


Similarly with real-time locating system (RTLS) technology, the impracticalities are apparent, first and foremost because simply tracking a member of staff’s location gives no actual insight into whether they are washing their hands regularly. Also, by tracking compliance on such an individual basis, the accountability for non-compliance becomes that much more personal. Of course, many would say that medical professionals should welcome the individual scrutiny that


By this notion, a group monitoring solution that promotes the spirit of collective responsibility amongst healthcare teams is ideal – something non-intrusive so not to disrupt workflow, whilst being sophisticated enough to gather genuinely accurate data.


The answer then, is electronic auditing – a cost-effective method that is considerably more reliable than direct monitoring, capturing 100% of hand hygiene events, which provides operators with precise, quantified data that enables them to increase compliance. And these systems can be established into a medical facility in a way that bears no detrimental impact to the daily activities of medical staff. State-of-the-art electronic numeration can be incorporated into the dispensers, meaning that a wireless signal will activate any time the dispenser is used and be sent to a tracking server. Then, by means of pre-determined algorithms on the basis of factors such as the healthcare provider to patient ratio, it is possible to measure what is happening more accurately and determine whether it falls in line with compliance standards.


After any given timeframe in which the dispensers have been tracking usage, the data can be presented to operators in the form of easy-to-digest web-based reports – allowing them the insight to make informed decisions on how certain teams or departments can improve.


Then, by clearly displaying hand hygiene trends and statistics for each hospital unit, staff can collaborate on compliance improvement plans, set goals and ensure that as a team they are doing everything in their power to improve hand hygiene and thus, patient safety.


If a monitoring system is combined with an integrated hand hygiene programme, hospitals can go a long way towards controlling infections – and protecting the skin health of healthcare workers at the same time.


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