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Assessment of an Aggregate-Level Hand Hygiene Monitoring Technology for Measuring Hand Hygiene Performance Among Healthcare Personnel

Published online by Cambridge University Press:  19 December 2016

Heather M. Limper*
Affiliation:
University of Chicago Medicine, Center for Healthcare Delivery Science and Innovation, Chicago, Illinois University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics, Chicago, Illinois
Lynn Slawsky
Affiliation:
University of Chicago Medicine, Infection Control Program, Chicago, Illinois
Sylvia Garcia-Houchins
Affiliation:
University of Chicago Medicine, Infection Control Program, Chicago, Illinois
Supriya Mehta
Affiliation:
University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics, Chicago, Illinois
Ronald C. Hershow
Affiliation:
University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics, Chicago, Illinois
Emily Landon
Affiliation:
University of Chicago Medicine, Center for Healthcare Delivery Science and Innovation, Chicago, Illinois University of Chicago Medicine, Infection Control Program, Chicago, Illinois
*
Address correspondence to Heather M. Limper, MPH, University of Chicago Medicine, Center for Healthcare Delivery Science and Innovation, 5841 South Maryland Ave Chicago, Illinois 60637 (hlimper@medicine.bsd.uchicago.edu).

Abstract

BACKGROUND

Despite significant advances in technological methods for hand hygiene surveillance, a lack of evidence prohibits comparison of systems to one another or against the current gold standard of direct observation.

OBJECTIVE

To validate a hand hygiene monitoring technology (HHMT) designed to capture hand hygiene behaviors aggregated at the hospital-unit level (GOJO Industries, Akron, OH).

METHODS

Our team followed a rigorous validation approach to assess the sensitivity and positive predictive value (PPV) of an HHMT. A planned path was first used to measure the accuracy of the system when purposefully activated by investigators. Next, behavioral validation was used to quantify accuracy of the system in capturing real-world behaviors.

RESULTS

During the planned path phase, investigators performed 4,872 unique events across 3 distinct hospital buildings varying in size and age since construction. Overall sensitivity across the medical center was 88.7% with a PPV of 99.2%. During the behavioral validation phase, trained direct observers recorded 5,539 unique events across 3 distinct hospital buildings. Overall sensitivity across the medical center was 92.7% and PPV was 84.4%.

CONCLUSION

Objective measures of sensitivity and PPV indicate the promise of the benefit of this and other HHMTs to capture basic behaviors associated with hand hygiene.

Infect Control Hosp Epidemiol 2017;38:348–352

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Pittet, D, Hugonnet, S, Harbarth, S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:13071312.CrossRefGoogle ScholarPubMed
2. Erasmus, V, Brouwer, W, van Beeck, EF, et al. A qualitative exploration of reasons for poor hand hygiene among hospital workers: lack of positive role models and of convincing evidence that hand hygiene prevents cross-infection. Infect Control Hosp Epidemiol 2009;30:415419.CrossRefGoogle ScholarPubMed
3. Glance, LG, Stone, PW, Mukamel, DB, Dick, AW. Increases in mortality, length of stay, and cost associated with hospital-acquired infections in trauma patients. Arch Surg 2011;146:794801.Google Scholar
4. Klevens, RM, Edwards, JR, Richards, CL Jr, et al. Estimating health care–associated infections and deaths in US hospitals, 2002. Public Health Report 2007;122:160166.Google Scholar
5. Whitby, M, Pessoa-Silva, CL, McLaws, ML, et al. Behavioural considerations for hand hygiene practices: the basic building blocks. J Hosp Infect 2007;65:18.CrossRefGoogle ScholarPubMed
6. Schneider, J, Moromisato, D, Zemetra, B, et al. Hand hygiene adherence is influenced by the behavior of role models. Pediatr Crit Care Med 2009;10:360363.CrossRefGoogle ScholarPubMed
7. Boyce, J, Chartier, Y, Chraiti, MN. WHO guidelines on hand hygiene in health care. World Health Organization website. http://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf. Published 2009. Accessed November 14, 2016.Google Scholar
8. Fries, J, Tolentino, SL, Thomas, G, Herman, T, Segre, AM, Polgreen, PM. Monitoring Hand Hygiene via Human Observers: How Should We Be Sampling? Paper presented at: 21st Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, April 2011; Dallas, TX.Google Scholar
9. Eckmanns, T, Bessert, J, Behnke, M, Gastmeier, P, Ruden, H. Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infect Control Hosp Epidemiol 2006;27:931934.Google Scholar
10. Srigley, JA, Furness, CD, Baker, GR, Gardam, M. Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. BMJ Qual Saf 2014;23:974980.Google Scholar
11. Haas, JP, Larson, EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:614.Google Scholar
12. Boyce, JM. Hand hygiene compliance monitoring: current prespectives from the USA. J Hosp Infect 2008;70:27.Google Scholar
13. Ward, MA, Schweizer, ML, Polgreen, PM, Gupta, K, Reisinger, HS, Perencevich, EN. Automated and electronically assisted hand hygiene monitoring systems: a systematic review. Am J Infect Control 2014;42:472478.Google Scholar
14. Limper, HM, Garcia-Houchins, S, Slawsky, L, Hershow, RC, Landon, E. A validation protocol: assessing the accuracy of hand hygiene monitoring technology. Infect Control Hosp Epidemiol 2016;37:10021004.Google Scholar
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