Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jul 10;3(1):e122.
doi: 10.1017/ash.2023.195. eCollection 2023.

Hand hygiene behavior change: a review and pilot study of an automated hand hygiene reminder system implementation in a public hospital

Arta Seferi  1 , Kalliopi Parginos  1 , Wiline Jean  2   3 , Christopher Calero  2 , Joshua Fogel  4   5 , Shantel Modeste  6 , Beverley-Ann Scott  6 , Marjorie Daly-Walsh  1 , Wilfredo Yap  1 , Manjinder Kaur  1 , Terence Brady  7   8 , Theresa Madaline  7   8   9   10
Affiliations
Review

Hand hygiene behavior change: a review and pilot study of an automated hand hygiene reminder system implementation in a public hospital

Arta Seferi et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: To review and study implementation of an automated hand hygiene reminder system (AHHRS).

Design: Prospective, nonrandomized, before-after quality improvement pilot study conducted over 6 months.

Setting: Medical-surgical unit (MSU) and medical intensive care unit (MICU) at a public hospital in New York City.

Participants: There were 2,642 healthcare worker observations in the direct observation (DO) period versus 265,505 in the AHHRS period, excluding AHHRS observations collected during the 1-month crossover period when simultaneous DO occurred.

Intervention: We compared hand hygiene adherence (HHA) measured by DO prior to the pilot and after AHHRS implementation. We compared changes in HHA and potential cross-contamination events (CCEs) (room exit and subsequent entry without HHA) from baseline for each biweekly period during the pilot.

Results: Engagement, education/training, data transparency, and optimization period resulted in successful implementation and adoption of the AHHRS. Observations were greater utilizing AHHRS than DO (265,505 vs 2,642, P < .01). Due to the expected Hawthorne effect, HHA was significantly less for AHHRS than DO in MSU (90.99% vs 97.21%, P < .01) and MICU (91.21% vs 98.65%, P < .01). HHA significantly improved from 86.47% to 89.68% in MSU (P < .001) and 85.93% to 91.24% in the MICU (P < .001) from the first biweekly period of AHHRS utilization to the last. CCE decreased from 73.42% to 65.11% in the MSU and significantly decreased from 81.22% to 53.19% in the MICU (P < .05).

Conclusions: We describe how an AHHRS approach was successfully implemented at our facility. With ongoing feedback and system optimization, AHHRS improved HHA and reduced CCE over time.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
BioVigil: how it works diagram. Copyright © BioVigil LLC; Reproduced with permission.
Figure 2.
Figure 2.
Percent HHA for the AHHRS.
Figure 3.
Figure 3.
Percent cross-contamination for the AHHRS.
Figure 4.
Figure 4.
Time to HHA analysis for all room exit observations.
See this image and copyright information in PMC

References

    1. Magill SS, O’Leary E, Janelle SJ, et al. Changes in prevalence of health care-associated infections in U.S. hospitals. N Engl J Med 2018;379:1732–1744. - PMC - PubMed
    1. Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:1198–1208. - PMC - PubMed
    1. Scott RD II. The Direct Medical Costs of Healthcare-associated Infections in U.S. Hospitals and the Benefits of Prevention. 2009. https://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf. Accessed January 3, 2023.
    1. World Health Organization. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. 2009. https://www.who.int/publications/i/item/9789241597906. Accessed January 3, 2023. - PubMed
    1. Gould DJ, Moralejo D, Drey N, Chudleigh JH, Taljaard M. Interventions to improve hand hygiene compliance in patient care. Cochrane Database Syst Rev 2017;9:Cd005186. - PMC - PubMed

LinkOut - more resources