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• W2890767087 abstract "•The monitoring of both time and place of hand hygiene (HH) activity is central to calculating HH performance and improved understanding of related behaviors.•HH performance of individual staff within health care professional groups varies greatly and is masked with aggregate performance reporting.•Eighty-three percent of missed HH opportunities occur as part of a consecutive series of missed events with no hand washing in between.•Electronic monitoring systems can easily be configured to collect HH performance data in zones that contribute to risk of infection outside of the patient environment such as the soiled utility room. BackgroundHand hygiene (HH) compliance in health care is usually measured against versions of the World Health Organization's “Your 5 Moments” guidelines using direct observation. Such techniques result in small samples that are influenced by the presence of an observer. This study demonstrates that continuous electronic monitoring of individuals can overcome these limitations.MethodsAn electronic real-time prompting system collected HH data on a musculoskeletal rehabilitation unit for 12 weeks between October 2016 and October 2017. Aggregate and professional group scores and the distributions of individuals’ performance within groups were analyzed. Soiled utility room exits were monitored and compared with performance at patient rooms. Duration of patient room visits and the number of consecutive missed opportunities were calculated.ResultsOverall, 76,130 patient room and 1,448 soiled utility room HH opportunities were recorded from 98 health care professionals. Aggregate unit performance for patient and soiled utility rooms were both 67%, although individual compliance varied greatly. The number of hand wash events that occurred while inside patient rooms increased with longer visits, whereas HH performance at patient room exit decreased. Eighty-three percent of missed HH opportunities occurred as part of a series of missed events, not in isolation.ConclusionsContinuous collection of HH data that includes temporal, spatial, and personnel details provides information on actual HH practices, whereas direct observation or dispenser counts show only aggregate trends. Hand hygiene (HH) compliance in health care is usually measured against versions of the World Health Organization's “Your 5 Moments” guidelines using direct observation. Such techniques result in small samples that are influenced by the presence of an observer. This study demonstrates that continuous electronic monitoring of individuals can overcome these limitations. An electronic real-time prompting system collected HH data on a musculoskeletal rehabilitation unit for 12 weeks between October 2016 and October 2017. Aggregate and professional group scores and the distributions of individuals’ performance within groups were analyzed. Soiled utility room exits were monitored and compared with performance at patient rooms. Duration of patient room visits and the number of consecutive missed opportunities were calculated. Overall, 76,130 patient room and 1,448 soiled utility room HH opportunities were recorded from 98 health care professionals. Aggregate unit performance for patient and soiled utility rooms were both 67%, although individual compliance varied greatly. The number of hand wash events that occurred while inside patient rooms increased with longer visits, whereas HH performance at patient room exit decreased. Eighty-three percent of missed HH opportunities occurred as part of a series of missed events, not in isolation. Continuous collection of HH data that includes temporal, spatial, and personnel details provides information on actual HH practices, whereas direct observation or dispenser counts show only aggregate trends." @default.
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• W2890767087 date "2019-01-01" @default.
• W2890767087 modified "2023-10-14" @default.
• W2890767087 title "Secondary measures of hand hygiene performance in health care available with continuous electronic monitoring of individuals" @default.
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• W2890767087 doi "https://doi.org/10.1016/j.ajic.2018.07.004" @default.
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