SANITEYES HAND SANITATION MONITORING
It is well documented that hand sanitation is a major factor in controlling the transmission of
infection
within healthcare and that an understanding of actual hand sanitation practices is
essential to improvement. What is the next step after concluding your institution has a very high
compliance
rate? New technology provides a new solution to this issue.
You might worry on what type of compliance rate you are measuring. Compliance is often taken
to
be synonymous with adherence rate, the ratio of acts of hand hygiene when the opportunity
exists to the total number of hand hygiene opportunities. Much emphasis has been placed on
1
the denominator where the opportunities are defined by the WHO five moments. The numerator
(acts
of hand hygiene) has often
been considered to any instance of hand sanitation, such as the
dispensing
of soap or disinfectant. The WHO has indicated the numerator should be the total
number of times an HCW was observed to have appropriately
washed his or her hands before
and
after a patient encounter. Appropriate hand sanitation for both washing or the application of
2
alcoholbased formulations requires both a sufficient duration and sufficient friction of application.
Most
institutions have a standard of 1520 seconds of washing as a required minimum, studies
have shown that most washes are significantly shorter. While the effect
of shortened washes
3
has received little attention, one study showed washing hands for 15 seconds achieves a
microbial
kill of 10
0.61.1
and for 30 seconds, 10
1.82.8
, more than a tenfold improvement.
4
Observation
has been called the "gold standard" of compliance monitoring as duration,
5
coverage and friction can be considered. Despite expense, privacy concerns and subjective
evaluation
issues,
institutions have used the "secret shopper" employment of coworkers for
surreptitious
observation and reporting of hand sanitation practices. The "secret shopper"
6
results are questionable because of the "Hawthorne effect", the tendency of some people to
perform
better and work harder when they are observed. This has been attributed to a 7.75fold
higher compliance rate for observation as co
mpared
to measurement of product use statistics
without
observation.
7
A
different method of hand sanitation compliance monitoring, the SanitEyes system ,
8
overcomes the issues associated with previous monitoring methods. It consists of an
inexpensive
system with a camera monitoring of the wash area attached to a processor for a
1
http://www.jointcommission.org/assets/1/18/hh_monograph.pdf p. 29
2
WHO guidelines on hand hygiene in health care http://www.who.int/gpsc/5may/tools/9789241597906/en/
p. 247
3
Infect Control Hosp Epidemiol1991; 12:4228.
4
http://cdaadc.ca/jcda/vol66/issue10/546.html
5
http://www.jointcommission.org/assets/1/18/hh_monograph.pdf p.19
6
http://www.healthleadersmedia.com/content/HOM228830/Secretshoppershelpimprovehandhygienecom
pliance.html
7
Scheithauer, et al. AJIC 2009; 37:83541
8
www.saniteyes.com
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