Approaches to hand hygiene monitoring: From low to high technology approaches

Masroor, Nadia; Doll, Michelle; Stevens, Michael P.; Bearman, Gonzalo

doi:10.1016/j.ijid.2017.09.031

Cited by 34 publications

(28 citation statements)

References 21 publications

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“…Hand hygiene is a simple and powerful infection prevention method. Monitoring the use of alcohol-based hand rubs of healthcare workers (HCWs) before and after contact with the patient and encouraging HCWs to remain bare below the elbows are easy and cost-effective measures that can be taken [34,35]. In addition, environmental hygiene should be enhanced.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey

Aşgın

Otlu

2020

Pathogens

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Although Corynebacterium striatum is part of the human flora, it has recently drawn attention both for its multidrug resistance and its role as an invasive infection/outbreak agent. This cross-sectional study aimed to determine the antimicrobial resistance and clonal relationships among C. striatum strains. In total, 81 C. striatum strains were identified using Phoenix-100 TM (BD, Sparks, MD, USA). The antimicrobial resistance of the strains was determined using the Kirby-Bauer disk diffusion method. Clonal relatedness among the strains was performed via arbitrarily primed polymerase chain reaction (AP-PCR). All 81 C. striatum strains were resistant to penicillin, cefotaxime, ciprofloxacin, and tetracycline, but susceptible to vancomycin and linezolid. The resistance rates to gentamicin, erythromycin, and clindamycin were 34.6%, 79%, and 87.7% respectively. AP-PCR results showed no predominant clone among the C. striatum strains. Corynebacterium striatum is reportedly the cause of an increasing number of invasive infections/outbreaks. Moreover, treatment options are limited. The study showed that vancomycin, linezolid, and gentamicin can be selected for the empirical treatment of C. striatum infections. Although no single-clone outbreak was observed in our hospital, small clonal circulations were observed within some units, indicating cross-contamination. Therefore, a comprehensive infection control program is warranted in future.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey

Aşgın

Otlu

2020

Pathogens

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“…[2][3][4] Although direct observation has several unique advantages, its limitations have generated interest in supplemental methods for monitoring HH performance. 3,[5][6][7][8] To address this issue, automated HH monitoring systems (AHHMSs) have been developed, the advantages and limitations of which have been identified. 3,[9][10][11][12] Several studies have found that AHHMS installation without sufficient supplementary activities may not result in improved HH performance rates.…”

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confidence: 99%

Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections

Boyce¹,

Laughman

Ader

et al. 2019

Infect. Control Hosp. Epidemiol.

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Objective:Determine the impact of an automated hand hygiene monitoring system (AHHMS) plus complementary strategies on hand hygiene performance rates and healthcare-associated infections (HAIs).Design:Retrospective, nonrandomized, observational, quasi-experimental study.Setting:Single, 93-bed nonprofit hospital.Methods:Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.Results:Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.Conclusion:Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.

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“…The other method of measuring adherence is product consumption which is not very accurate and provides little information 17. Inaccuracies associated with manual hand hygiene audit are such that it is no longer considered the best approach and there is increasing interest in combining periodic manual audit with continuing electronic monitoring to give an overall picture of behaviour 51 52. Clearly, a controlled study is required to compare the introduction of an electronic audit and feedback system into current practice to improve hand hygiene compliance with current practice in order to validate the outcomes of this analysis.…”

Section: Discussionmentioning

confidence: 99%

Modelling the costs and consequences of reducing healthcare-associated infections by improving hand hygiene in an average hospital in England

et al. 2019

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ObjectiveTo assess the potential clinical and economic impact of introducing an electronic audit and feedback system into current practice to improve hand hygiene compliance in a hypothetical general hospital in England, to reduce the incidence of healthcare-associated infections (HCAIs).MethodsDecision analysis estimated the impact of introducing an electronic audit and feedback system into current practice to improve hand hygiene compliance among front-line healthcare practitioners (HCPs).ResultsThe model assumed 4.7% of adult inpatients (ie, ≥18 years of age) and 1.72% of front-line HCPs acquire a HCAI in current practice. The model estimated that if use of the electronic audit and feedback system could lead to a reduction in the incidence of HCAIs of between 5% and 25%, then the annual number of HCAIs avoided could range between 184 and 921 infections per hospital and HCAI-related mortality could range between 6 and 31 deaths per annum per hospital. Additionally, up to 86 days of absence among front-line HCPs could be avoided and up to 7794 hospital bed days could be released for alternative use. Accordingly, the total annual hospital cost attributable to HCAIs could be reduced by between 3% and 23%, depending on the effectiveness of the electronic audit and feedback system. If introduction of the electronic audit and feedback system into current practice could lead to a reduction in the incidence of HCAIs by at least 15%, it would have a ≥0.75 probability of affording the National Health Service (NHS) a cost-effective intervention.ConclusionIf the introduction of the electronic audit and feedback system into current practice in a hypothetical general hospital in England can improve hand hygiene compliance among front-line HCPs leading to a reduction in the incidence of HCAIs by ≥15%, it would potentially afford the NHS a cost-effective intervention.

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Approaches to hand hygiene monitoring: From low to high technology approaches

Cited by 34 publications

References 21 publications

Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey

Antimicrobial Resistance and Molecular Epidemiology of Corynebacterium striatum Isolated in a Tertiary Hospital in Turkey

Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections

Modelling the costs and consequences of reducing healthcare-associated infections by improving hand hygiene in an average hospital in England

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