Background: Poor hand hygiene by health care workers is a major cause of nosocomial infections. This research evaluated the ability of an electronic monitoring system with real-time prompting capability to change hand hygiene behaviors.


Methods: Handwashing activity was measured by counting dispenser activations on a single nursing unit before, during, and after installation of the system. The effect of changing the prompt duration on hand hygiene performance was determined by a cluster-randomized trial on 3 nursing units with 1 acting as control. Sustainability of performance and participation was observed on 4 nursing units over a year. All staff were eligible to participate.

Results: Between June 2015 and December 2016, a total of 459,376 hand hygiene opportunities and 330,740 handwashing events from 511 staff members were recorded. Dispenser activation counts were significantly influenced by use of the system (χ2[3] = 75.76; P < .0001). Hand hygiene performance dropped from 62.61% to 24.94% (odds ratio, 0.36; 95% confidence interval, 0.34-0.38) when the prompting feature was removed. Staff participation had a negative trajectory of –0.72% (P < .001), whereas change in average performance was –0.18% (P < .001) per week for the year.

Conclusions: Use of electronic monitoring with real-time prompts of 20 seconds' duration nearly doubles handwashing activity and causes handwashing to occur sooner after entering a patient room. These improvements are sustainable over a year.

Voor volledig artikel klik hier, gepubliceerd in American Journal of Infection Control, volume 46, issue 7, July 2018, 768-774

Auteurs: Steven Pong (a,b), Pamela Holiday (a,c), Geoff Fernie (a,b,c,d)

a) iDAPT, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada

b) Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada

c) Department of Surgery, University of Toronto, Toronto, Ontario, Canada

d) Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, O

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