Obstacles to the successful introduction of an electronic hand hygiene monitoring system, a cohort observational study

Hand hygiene (HH) compliance remains low in many intensive care units (ICU). Technology has been suggested to improve HH compliance.We describe the introduction of an electronic HH surveillance and intervention system into the general ICU of a tertiary care teaching hospital, the obstacles to succes...

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Bibliographic Details
Published in:Antimicrobial resistance & infection control 2019-02, Vol.8 (1), p.43-5, Article 43
Main Authors: Levin, Phillip D, Razon, Reut, Schwartz, Carmela, Avidan, Alexander, Sprung, Charles L, Moses, Allon E, Benenson, Shmuel
Format: Article
Language:English
Subjects:
Accuracy
Alcohol
Analysis
Bracelets
Cohort Studies
Compliance
Correlation coefficient
Cross Infection - prevention & control
Data Collection
Disease control
Dispensers
Drug resistance
Electronic Data Processing
Electronic HH system
Guideline Adherence - statistics & numerical data
Hand hygiene
Hand Hygiene - methods
Health aspects
Hospital patients
Hospitals
Hospitals, Teaching
Humans
Hygiene
Infection control
Infection Control - methods
Intelligence gathering
Intensive care
Intervention
Jewelry
Male
Monitoring systems
Nosocomial infections
Observational studies
Patients
Personal hygiene
Population Surveillance - methods
Questionnaires
Sensors
Studies
Success
Surveillance
Surveys and Questionnaires
Technology
Telecommunications equipment
Tertiary Care Centers
Transmitters
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Summary:Hand hygiene (HH) compliance remains low in many intensive care units (ICU). Technology has been suggested to improve HH compliance.We describe the introduction of an electronic HH surveillance and intervention system into the general ICU of a tertiary care teaching hospital, the obstacles to success and reasons for the system's ultimate failure and removal. The system was based on radiofrequency transmitters in patient areas, on HH dispensers, and individual personal bracelets. The transmitters were connected to a central computer. The system was designed to detect entry and exit from patient areas and provide real time alerts of missed HH performance A staff satisfaction questionnaire was administered followed by validation of system accuracy. Electronic data were compared to human observer data collected during defined observation periods. Data from 41 questionnaires revealed low satisfaction rate (21/41, 51%). Low system accuracy (31/41, 76%) and inconvenience (18/41, 44%) being the most frequent reasons.During 44 one hour observation periods the observer recorded more HH opportunities and performances than the electronic system (mean number of HH opportunities/hour 10.9 ± 7.6 vs 6.8 ± 6.9,  
ISSN:2047-2994
2047-2994
DOI:10.1186/s13756-019-0498-2