INFECTION PREVENTION
to an explanation of GOJO’s product in the study summary.
The data collected by these devices can reveal useful information to healthcare facility leadership and staff, not only by looking at day to day hand hygiene com- pliance, but by revealing more long-term compliance trends. For instance, Rosenthal of GOJO said, “Hand hygiene compliance rates increased dramatically during the first few months of the pandemic but have since gone back to more typical levels for hospitals.” An ability to pinpoint such information
accurately can assist healthcare workers in reversing those compliance declines and help save lives in the process.
The Hawthorne Effect GP PRO’s own MS, the SafeHaven Personal Hand Hygiene Monitoring System, was activated in April of this year at Gulfside Healthcare Services facilities in Pasco County, Florida.
Gulfside issued the small device to 220
employees who work in hospice, home health and palliative care. The portable device clips onto clothing or a lanyard, which allows the user to perform hand hygiene at any time. A small screen on the device shows the user their indi- vidual performance data. ach time a user passes one of several base stations, that data is uploaded to the Cloud and is then available on a live facility dashboard that displays aggregated facility data for management.
“You can also log in as a personal user,”
to check on your own hand hygiene habits, said Lindsay Cole, who runs nursing and CNA training programs at Gulfside, and helped implement the system trials. Custom programming allows each facility to set and alter goals for different users, “depending on what is realistic for a particular job,” Cole said. “Some of our staff members visit five or six locations a day, so these (devices) are our eyes when employees are off-site.” Cole said she has staff members train other staff members, and publicly rec- ognizes employees whose hand hygiene behavior is exemplary. Data generated by SafeHaven and other electronic hand hygiene monitor- ing systems, over the course of the last several years, have become increasingly regarded as reliable, according to a study published last year in the Journal of Infection Prevention. The study, conducted in a National Health Service acute care medical ward in the United Kingdom, sought to measure the accuracy of MS products as compared
with manual observation-documentation techniques.2
Those techniques, which rely
upon human monitors, are still the indus- try standard for hand hygiene compliance monitoring. fficiency of MS, according to the study’s summary, “is estimated to be tenfold compared to manual monitoring.” “Less effort is required (with MS) than
with manual observation which is labori- ous, expensive in terms of manpower and subject to bias,” according to the summary. The range of electronic monitoring systems now on the market has grown sig- nificantly in a few short years. The ongoing pandemic provided the necessary incentive for an increasing number of healthcare facility leaders to take the leap and invest in monitoring technology. Among electronic products now on
the market is colab’s Hand Hygiene Compliance Monitoring System, which works by employing what its website lit- erature calls the “Patient Zone.” The system defines an area around a hospital patient’s bed for electronic monitoring, “to detect every hand- hygiene opportunity.” A badge worn by healthcare workers,
“measures and records every hand hygiene event,” colab’s website explains. “Visual and audible feedback is immediate.” Data is compiled, “to track perfor- mance by individual, department hospi- tal or system,” according to the website. “Compliance trends are reported as well as equipment status, sanitizer,” etc. Paul Alper is now the VP Patient Safety Innovation for Medline Industries, Inc. through an exclusive engagement with his consulting practice, Next Level Strategies, LLC. Medline recently formed a col- laborative partnership with Intelligent Observation, to offer a hand hygiene compliance monitoring system under the brand name, IntelObserve. The technology platform behind the product – Near Field Magnetic Induction or NFMI is new and different, Alper said. The system monitors, “both hand wash-
ing with soap and water and the use of hand sanitizer with a high rate of accuracy”, he said, “providing highly actionable data to drive sustainable improvement.” Alper, like Artzerounian of Vizient, noted that technology-based compliance monitoring is beginning to gain real traction.
The uptick in interest is due, in part, he
said, to Medicare reimbursement penal- ties for Hospital-Acquired Conditions (HACs), and to increased standards for hand hygiene compliance, generally. Those standards have leapt forward, thanks to an
32 October 2021 • HEALTHCARE PURCHASING NEWS •
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industry watchdog organization called the Leapfrog Group. Leapfrog issues a grade to each hospital that is willing to be transpar- ent with patient safety records and most hospitals are. The grades are posted on the group’s website. But the tipping point that may very well change the landscape of hand hygiene entirely is the emergence and persistence of COVID-1. It doesn’t hurt proponents of MS that a number of reputable institutions have now compared their rates of accuracy and influence on behavior to the traditional, human means of monitoring hand hygiene compliance.
According to results from the University
of Chicago study, MS is “far more effec- tive than human observation in measuring compliance.”
One reason for the difference, accord- ing to the study summary, is that mere observation practices capture too few hand hygiene events, “leading to inaccurate measurements.” MS can help resolve those inaccuracies
by monitoring consistently, and constantly. Inaccuracy created through traditional human monitoring, according to the U.K. study, is due also to the “Hawthorne ffect.” This principle posits that human behavior changes when the subject being monitored is aware that he is being observed by another person. Hand hygiene compliance, according
to this principle, will increase during the time a subject is being monitored in this way, then drop off precipitously once the perceived observation ends, according to the principle. Compliance data, when collected in this
way, can be skewed, “by a factor of three,” according to the U.K. study.
The evidence from such studies, Alper said, suggests that long-accepted methods of direct observation, “lead to overstated compliance and a false sense of security.” And that, he says, leads to complacency. These studies no doubt contribute to the growing popularity of MS. It’s a theme familiar to Vizient’s Yessica Artzerounian. “We expect to see an increase in use for
these systems as we continue to navigate through COVID hospitalization spikes and the upcoming flu season,” she said. “2021 and 2022 will be watershed years,” said Alper. Technology-based hand hygiene monitoring systems, “are going to be much more widely adopted.” HPN
References
1.
https://jamanetwork.com/journals/jamainternalmedicine/ fullarticle/2779293/
2.
https://journals.sagepub.com/doi/full/10.1177/1757177 420907999
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