Muhammad Javed, MD, FCCP, FCCM,FCCM
Associate Program Director
Mercy Hospital Saint Louis
Saint Louis, Missouri, United States
Disclosure information not submitted.
Title: Effectiveness of Electronic Monitoring System on Healthcare Workers’ Compliance With Hand Hygiene
Introduction: Healthcare-associated infections (HCAIs) can lead to higher mortality and morbidity in ICU patients. Contaminated healthcare workers’ (HCW) hands have been associated with HCAIs. Hand hygiene (HH) is the primary measure proven to be effective in preventing HCAI and the spread of antimicrobial resistance. However, it has been shown that HCWs have low compliance rates with hand hygiene recommendations and procedures. The aim of this quality improvement project is to evaluate the impact of an electronic monitoring system (EMS) on compliance with hand hygiene of HCWs in the ICU.
Methods: Compliance data were collected on all HCWs caring for patients in a 100-bed ICU (Med-surg, Neuro, and CVICU) in a large training-hospital for 6 months prior and 6 months after implementation of EMS for HH. EMS consists of a sensors, dispenser monitors, and badges. A sensor is placed in each patient’s room, maps out the patient environment, and senses the activity of the HCW around the patient. The dispensing monitor identifies usage when a HCW presses on the bottle's pump to dispense and identifies a HCW badge in its immediate sensing range, which will exactly note when and where a HCW is using the sanitizer. Each HCW receives a personal badge, which he/she has to wear while in the ICU. When the badge gets into the range of a sensor, the system will know that the HCW is in the environment of the patient. When a HCW dispenses from a dispensing monitor, the badge will record information that the HCW has cleaned his/her hands. An audio also reminds HCW to “please clean hands”. Successful and unsuccessful HH events are recorded in the database.
Results: A total of 60000 HH events were reviewed. For all HCWs, compliance rates improved from 23 % before to 56 % after implementation of EMS (p < 0.0001). For attendings and fellows, compliance rates improved from 48 % before to 67 % after (p < 0.0001).
Conclusion: In a large community teaching hospital, our data demonstrate that EMS technology can be used effectively in promoting and improving hand hygiene compliance among HCWs in the ICU.