Clinical Evaluation with Automated Hand Hygiene Monitoring System: A Prospective Observational Study on Compliance Improvement Using Feedback Data

Abstract

Background Hand hygiene compliance (HHC) among healthcare workers (HCWs) remains suboptimal. Hand hygiene (HH) among HCWs is regarded one of the most effective measures to reduce healthcare-associated infections. We aimed to evaluate HH improvement in HCWs using an automated monitoring system to provide systematic feedback on staff HHC. Methods A prospective observational study was conducted in a Danish medical hospital ward (23 beds) between February-November 2020. Sensors were placed on alcohol-based sanitizers, HCW name tags, and patient beds. The sensors measured HH opportunities and sanitizations to be able to provide compliance feedback to staff groups and individuals. Baseline data were obtained before the reporting of feedback data. HCWs were grouped as caregivers (n=58) and doctors (n=18). Rooms were classified by type e.g., medication room and patient room. Overall data was regularly presented to the staff group and subgroups, caregivers, and doctors. Student's t-test was used for comparisons. A two-tailed value of p Results Baseline was performed twice (at weeks 4 and 5 because the COVID19 pandemic interrupted the study for a period). Both baselines showed similar initial compliance among HCW. Baseline HHC was lowest before patient contact (BPC) compared to after patient contact (APC) for both the doctors (16% vs. 26%) and the nurses (22% vs. 39%). Once data were shown and feedback provided, both the doctors (BPC: 16% vs. 24%, p=0.014; APC: 26% vs. 35% p=0.059) and caregivers (BPC: 22% vs. 37%, p Conclusions Feedback data from the automated hand hygiene monitoring system helped the HCWs to improve their HHC significantly.