Becker's Clinical Quality & Infection Control

Executive Briefing: Electronic Surveillance of Hand Hygiene 13 Sponsored by: Putting the "E" in HygiEne Hand hygiene compliance monitoring via electronic surveillance is proven to increase compliance, help reduce the incidence of patient infection and drive down care costs. By Paul Alper, Vice President, Strategy and Business Development, DebMed I nfection control and prevention is a major challenge faced by hospitals, surgery centers and long-term care facilities. Patient infections lead to more complex care cases and longer hospital stays — a lose-lose situation for both patients and hospitals. Healthcare-acquired infections impact patient safety, economics and continuity of care, making it a top quality issue for healthcare decision-makers. It is well known that proper hand hygiene is the primary way to prevent these infections, and studies have shown that increased compliance can reduce the frequency of HAIs. Unfortunately, current methods to achieve higher compliance have not proven successful. The average rate of compliance across U.S. hospitals has remained around 40 to 50 percent for nearly a decade. • After body fluid exposure/risk, • After touching a patient, and • After touching patient surroundings. These moments align with the evidence base concerning the spread of HAIs, which are among the leading cause of preventable deaths and increased healthcare costs in the U.S. The WHO Five Moments for Hand Hygiene guidelines also correspond with the Centers for Disease Control and Prevention recommendations. Studies show that when staff only clean hands before and after patient care, a common standard in hospitals, it only accounts for half of all hand hygiene opportunities, potentially putting patients at risk. There is a better way Hospitals are well aware of the safety and financial advantages of hand hygiene compliance. Unfortunately, The Joint Commission on Accreditation of Healthcare reports that the average hand hygiene rate of healthcare workers in the U.S. is only 48 percent. Current methods of monitoring, typically in the form of direct observation, bring various drawbacks including: Saving lives by eliminating medical complications and errors is essential in providing the highest level of care. Consider how proactive decisions about infection control could translate to improved outcomes and reduced costs. Revolutionary hand hygiene electronic monitoring technologies, such as the DebMed GMS™ (Group Monitoring System), can help deliver on the institution's key mission of better care delivery, while improving communication around true hand hygiene compliance rates among the nursing staff, physicians and infection control practitioners. In today's era where significant funds are being spent on electronic health records, electronic monitoring of hand hygiene represents a mere fraction of the cost, and contributes to hospitals' ability to demonstrate improved patient outcomes, such as shorter lengths of stay and lower mortality rates, with significant cost savings in their operations. The Hawthorne Effect: People behave differently while being watched; workers improve or modify their habits, which results in inaccurate and overinflated compliance data being reported. DebMed® has developed the world's first electronic hand hygiene compliance monitoring system based on the World Health Organization's Five Moments for Hand Hygiene, providing accurate, real-time feedback to help hospital staff increase compliance and decrease the spread of preventable and deadly infections. A higher clinical standard The DebMed GMS is based on the World Health Organization's Five Moments for Hand Hygiene, which advises healthcare workers to clean their hands in the clinical setting: • Before touching a patient, • Before clean/aseptic procedures, Small sample sizes: Due to cost and manpower limitations, direct observation techniques only capture 1.2 to 3.5 percent of all hand hygiene opportunities according to a study done at University of Iowa. Observer bias: The staff doing the observations may not be properly trained, and inter-rater reliability means that one observer may interpret activities differently than another observer. To put it simply, manual, costly strategies for monitoring hand hygiene compliance executed by staff are unreliable. Not to mention that staff, including nurses, should be devoting their time to patient care and not manual tracking. The DebMed GMS is impartial and unbiased, and eliminates challenges associated with the human element. The system captures 100 percent of hand hygiene events with accuracy, reported in real-time. Using statistically-validated algorithms, the technology automatically calculates compliance rates, and additionally provides supporting educational tools to enable behavioral changes to help hospitals improve staff compliance.

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