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Survey: Hand Hygiene at Hospitals Progressing Towards Electronic Monitoring

October 23, 2014
by Rajiv Leventhal
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Nearly 80 percent of infection preventionists, nurses, and other healthcare leaders from U.S. hospitals believe electronic hand hygiene compliance monitoring is a more accurate option than direct observation, yet most facilities are still relying more on manual methods, according to a survey from DebMed, the creator of an electronic hand hygiene compliance monitoring system.

The survey, which included more than 400 respondents, reveals a vast inconsistency in hand hygiene compliance reporting, ultimately leaving patients and clinical staff at risk for infection.

While 78 percent believe electronic hand hygiene compliance monitoring is a more accurate option than direct observation, 62 percent use manual direct observation by staff as the primary method used to measure and report hand hygiene compliance, with another 34 percent using manual direct observation by "secret shoppers."

With that said, 88 percent believe the Hawthorne effect, which states that people will change their behavior if they know they are being watched, impacts the accuracy of reported hand hygiene compliance rates. To this end, a study published on-line this summer in the BMJ Quality & Safety Journal, found that hand hygiene rates were found to be three times higher when auditors were visible to healthcare workers than when there were no auditors present.

However, in looking back at the survey data collected the previous two years, there is a positive trend in not only the adoption of better technologies, but also the more imminent plans for purchase among those not yet using electronic monitoring.

  • There is a two percent increase in facilities using electronic monitoring since 2012
  • 43 percent surveyed said they are currently considering implementing an electronic monitoring system, and 33 percent said their facility intends to purchase an electronic monitoring system within the next year

Other key findings include:

  • 66 percent of respondents said their facility reports hand hygiene compliance to be 81 percent or greater, however,
  • 59 percent believe that their true hand hygiene compliance is actually less than 70 percent
  • 13 percent of those surveyed said they are "extremely satisfied" by the reliability of their facility's hand hygiene compliance data

Further, the survey findings cite the oft-used "in and out" method of only cleaning hands before and after patient interaction still reigns at most facilities, despite the fact that data shows additional hand cleaning—such as after touching a bed rail or medical chart—lowers infection rates.

"The survey results are promising, yet accurately represent the challenges the industry faces in regard to clean hands and safer care for patients," Heather McLarney, vice president of marketing, DebMed, said in a statement. "The numbers confirm what we hear firsthand from infection preventionists. They and other hospital staff want to implement the best hand hygiene practices for improved patient safety and health, but they face the reality of a host of other IT priorities competing for funding and focus like meaningful use, ICD-10 and EHR implementations."

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