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Impact of an automated hand hygiene monitoring system combined with a performance improvement intervention on hospital-acquired infections

Published online by Cambridge University Press:  28 May 2020

Bryan C. Knepper Open the ORCID record for Bryan C. Knepper [Opens in a new window] ,
Amber M. Miller  and
Heather L. Young
Bryan C. Knepper*
Affiliation:
Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado
Amber M. Miller
Affiliation:
Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado University of Colorado Health, Aurora, Colorado
Heather L. Young
Affiliation:
Department of Patient Safety and Quality, Denver Health Medical Center, Denver, Colorado Department of Medicine and Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, Colorado
*
Author for correspondence: Bryan Knepper, E-mail: bryan.knepper@dhha.org
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Abstract

Objective:

Hand hygiene adherence has been associated with reductions in nosocomial infection. We assessed the effect of improvements in electronically measured hand hygiene adherence on the incidence of hospital-acquired infections.

Methods:

This quasi-experimental study was conducted in a 555-bed urban safety-net level I trauma center. The preintervention period was January 2015 through June 2016. Baseline electronic hand hygiene data collection took place from April through June 2016. The intervention period was July 2016 through December 2017. An electronic hand hygiene system was installed in 4 locations in our hospital. Performance improvement strategies were implemented that included education, troubleshooting, data dissemination, and feedback. Adherence rates were tracked over time. Rates of hospital-acquired infections were evaluated in the intervention units and in control units selected for comparison. The intervention period was subdivided into the initial and subsequent 9-month periods and were compared to the baseline period.

Results:

Electronically measured hand hygiene rates improved significantly from baseline to intervention, from 47% 77% adherence. Rates >70% continued to be measured 18 months after the intervention. Interrupted time series analysis indicated a significant effect of hand hygiene on healthcare facility-onset Clostridioides difficile infection rates during the first 9 months of the intervention. This trend continued during the final 9 months of the intervention but was nonsignificant. No effects were observed for other hospital-acquired infection rates.

Conclusions:

Implementation of electronic hand hygiene monitoring and performance improvement interventions resulted in reductions in hospital-onset Clostridioides difficile infection rates.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 8 , August 2020 , pp. 931 - 937
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Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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