INFECTION CONTROL
plate and improve their digital capabilities. In 2016, the Government announced the first 23 global exemplars – NHS Trusts who were picked because they were already considered digitally advanced. Each exemplar was told that they would receive £10 million in central funding, to advance them further and help them to become a blueprint for exemplary digitalisation in the NHS. By the end of this year, NHS England is expected to announce additional ‘place-based’ exemplars. These exemplars will be incredibly useful in improving hand hygiene and compliance across the healthcare sector. They will demonstrate how effective technology can be in monitoring the hand hygiene events that take place within institutions when the right data is available, along with the infrastructure to collect and analyse that data.
The exemplars will also be a clear example for other NHS Trusts and institutions to follow. However, for hospitals to achieve exemplar status, the right digital solutions must be chosen. Hand hygiene is of critical importance in healthcare environments, and something which technology can help to improve.
Choosing the right solution for monitoring compliance
Technology has made major advances in hand hygiene monitoring in recent times. 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.
As this field of technology has grown,
Electronic monitoring is a simple and effective way of ensuring that staff are participating in hand washing.
a wide range of potential solutions have been developed, often with very different approaches taken and very different outputs created. This in itself creates new challenges, as healthcare leaders do not yet know which systems should be supported. Options emerging include video
surveillance, which, although highly accurate and rigorous, is also extremely burdensome to operate on a 24/7 basis. Such systems are likely to find utility only in the context of academic studies or as an intervention tool in cases of persistent poor practice or stubbornly high infection rates.
Many systems monitor individual staff members and track both staff movements as well as hand-hygiene practice. ‘Compliance’ is typically derived by ‘counting’ hand hygiene opportunities by location close to patients, and then by ‘counting’ adherence by location close to sanitiser or hand wash dispensers. While such systems offer data at the individual level, high overhead costs plus data reliability limit their effectiveness. Furthermore, while individual data is appealing, the reality of both managing it and implementing interventions is both logistically and culturally troublesome.
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