Microbes spread quickly in an outpatient clinic, reaching maximum contamination levels 2 hours after inoculation, with the highest contamination on examination room door handles and nurses' station chairs. This study emphasizes the importance of targeted disinfection of high-touch surfaces.

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multi-specialty academic medical centers implemented automated hand hygiene (HH) monitoring to improve HH protocol in a 16-bed ambulatory surgical center (ASC). These centers noted medical practitioner compliance was higher upon patient room entry than upon patient room exit. They hypothesized there to be differences between entry and exit compliance in an ASC setting as opposed to an adult medical-surgical and critical care units. The objective of this study is to evaluate the difference in HH performance in diverse healthcare settings. METHODS: In January 2014, HH monitoring was implemented in Same Day Surgery (SDS) to assess 38 HH solution dispensers and 23 caregivers. This 11 month analysis included over 26,297 hours of caregiver activity, 35,503 patient interactions and 40,468 hand cleansings. SDS data was compared to aggregate de-identified compliance data for 63 nursing units in 37 hospitals for the same 11 month period, including over 575,414 hours of caregiver activity, 6,878,842 patient interactions, and 24,665,435 hand cleansings. HH compliance on entry and exit was measured for both SDS and the aggregated units. RESULTS: SDS HH solution dispensing increased by 103.6%, dispenses per patient care episode increased 146.7%, and compliance increased 332.5% (x2 p < .0001). SDS compliance upon room entry was 34% higher than upon exit (x2 p < .0001). Entry compliance for the aggregated units was 7.9% lower than compliance on exit (x2 p < .0001). Average entry compliance for Same Day Surgery was 32.3% and exit compliance was 21.3%. Average aggregate unit entry compliance was 63.0% and exit compliance was 68.0%. CONCLUSIONS: Automated technology used to assess HH compliance indicated that HH performance in the ASC differed significantly from aggregated adult inpatient medical-surgical and critical care units. This data can be used to improve employee HH protocols in medical institutions.