by Most people would respond saying “That depends on what those numbers correlate to”. Let’s put these numbers into perspective.
John M. Boyce, MD, of the Hospital of Saint Raphael in New Haven, CONN and clinical professor of medicine at Yale University School of Medicine (2011) states that less than 1 percent to 3 percent of all hand hygiene opportunities in health-care settings are captured using the direct observation method. Is this a statistically significant sample rate to base compliance rates for an entire population of Health Care Workers (HCW’s)? There is a growing voice that thinks it is not.
One in twenty patients who enters a health-care facility contracts a Health-Care Associated Infection (HAI) that cause 99,000 deaths each year in the U.S. When we single out the greatest contributor to HAI’s is poor hand hygiene compliance (in the range of 45%-50%) the confidence in such a small number of human observations begs for change.
HOW CAN 80% OF ALL HAND HYGIENE OPPORTUNITIES BE CAPTURED?
Although hand hygiene has been the target of continuous scrutiny, study and awareness campaigns, Erasmus, et al. (2010) states that substantial and lasting effects on compliance rates has been minimal using the industry standard methodologies. As healthcare institutions continue to wrestle with this issue, manufacturers have stepped in to offer high tech solutions to this perennial problem. The study further states that automated hand hygiene monitoring systems may offer a reliable method of measuring individual hand hygiene compliance. Many of these technologies can monitor up to 80% of all the hand hygiene opportunities with accuracy levels in the 99% range.
WHAT ARE THE ADVANTAGES OF THESE HHCM TECHNOLOGIES?
According to Stewardson and Pittet (2011), the potential advantages of automated systems include minimal consumption of resources once installed, provision of large data sets, and potentially less observation bias or Hawthorne effect.
They also found that HCW’s know the risks posed by inadequate hand hygiene and want to improve. They want access to their own hand hygiene performance results and they dislike being observed without feedback. Many of the emerging HHCM technologies can provide this feedback to encourage the correct hand hygiene behaviors during patient care.
Once installed many of these technologies can provide real time data on individual and group compliance allowing management the unbiased data to identify which health care workers need additional training and which ones are setting new compliance standards.
Like any new emerging technology, continuous improvements are part of the charter. As health care institutions become strategic partners and embrace the benefits of HHCM automation, together they can build solutions that will drive patient safety to new levels of excellence.
NOW, HOW WOULD YOU ANSWER THE QUESTION, WHICH NUMBER IS BETTER?
References:
Boyce JM. Measuring healthcare worker hand hygiene activity: Current practices and emerging technologies. Infect control Hosp Epidem. Vol. 32, No. 10. Pp. 1016-1028. October 2011.
ErasmusV, et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect control Hos Epidem. Vol. 31, No 3. Pp. 283-294. March 2010.
Stewardson A and Pittet D. Quicker, easier and cheaper? The promise of automated hand hygiene monitoring. Infect Control Hosp Epidemiol. Oct;32 (10): 1029-31. 2011
