Adoption of Electronic Hand Hygiene Monitoring Systems in NYS Hospitals and the Impact on Hospital-Acquired C. Difficile Infection Rates

Abstract

Background Despite rigorous infection control efforts, hospital-acquired infections (HAIs) remain a challenge for providers. Approximately 721,800 HAIs occur annually, generating an estimated $10 billion in costs. Proper hand hygiene (HH) is paramount for preventing HAIs, yet adherence with standard practices averages 50%. Electronic hand hygiene monitoring systems (EHHMS) are a potential solution, using sensor technology to track and signal HH events. Methods We explored adoption of EHHMS in New York State acute care hospitals through a survey and interviews. The impact of EHHMS on HAIs was also assessed by examining rates of hospital-acquired C. difficile infection (HA-CDI) pre- and post-implementation of this technology using trend analysis. Results Survey respondents represented approximately 30% (N = 56) of the total population of hospitals (N = 184) and EHHMS adoption was low (N = 2). Reasons for non-adoption were cost (79.6%) and concerns for accuracy in tracking HH events (28.6%). HH compliance increased 20-30% and HA-CDI decreased 70% for one hospital after EHHMS implementation, though this was not sustained. A robust HH culture was mentioned as a necessary accompaniment to electronic tracking. The second hospital declined to share their experience, and the trend analysis indicated no discernible impact on HA-CDI post-EHHMS implementation. A critical access hospital without an EHHMS reported HH compliance of 90%, which they attributed to strong HH culture. Conclusions Proliferation of EHHMS is low in NYS acute care hospitals and the impact of this technology on HH compliance and infection rates is so far questionable. With or without an EHHMS, a strong organizational culture in support of HH seems essential to achieving high compliance rates. Despite rigorous infection control efforts, hospital-acquired infections (HAIs) remain a challenge for providers. Approximately 721,800 HAIs occur annually, generating an estimated $10 billion in costs. Proper hand hygiene (HH) is paramount for preventing HAIs, yet adherence with standard practices averages 50%. Electronic hand hygiene monitoring systems (EHHMS) are a potential solution, using sensor technology to track and signal HH events. We explored adoption of EHHMS in New York State acute care hospitals through a survey and interviews. The impact of EHHMS on HAIs was also assessed by examining rates of hospital-acquired C. difficile infection (HA-CDI) pre- and post-implementation of this technology using trend analysis. Survey respondents represented approximately 30% (N = 56) of the total population of hospitals (N = 184) and EHHMS adoption was low (N = 2). Reasons for non-adoption were cost (79.6%) and concerns for accuracy in tracking HH events (28.6%). HH compliance increased 20-30% and HA-CDI decreased 70% for one hospital after EHHMS implementation, though this was not sustained. A robust HH culture was mentioned as a necessary accompaniment to electronic tracking. The second hospital declined to share their experience, and the trend analysis indicated no discernible impact on HA-CDI post-EHHMS implementation. A critical access hospital without an EHHMS reported HH compliance of 90%, which they attributed to strong HH culture. Proliferation of EHHMS is low in NYS acute care hospitals and the impact of this technology on HH compliance and infection rates is so far questionable. With or without an EHHMS, a strong organizational culture in support of HH seems essential to achieving high compliance rates.