Comparison of two electronic hand hygiene systems using real-time feedback via wireless technology to improve hand hygiene compliance in an intensive care unit

Abstract

Background: Most hand hygiene (HH) intervention studies use a quasi-experimental design, are primarily uncontrolled before-and-after studies, or are controlled before-and-after studies with a nonequivalent control group. Well-funded studies with improved designs and HH interventions are needed. Objectives: To evaluate healthcare worker (HCW) HH compliance with alcohol-based hand rub (ABHR) through direct observation (human observer), 2 electronic technologies, a radio frequency identification (RFID) badge system, and an invasive device sensor. Methods: In our controlled experimental study, 2,269 observations were made over a 6-month period from July 1 to December 30, 2020, in a 4-bed intensive care unit. We compared HH compliance between a basic feedback loop system with RFID badges and an enhanced feedback loop system that utilized sensors on invasive devices. Results: Real-time feedback by wireless technology connected to a patient’s invasive device (enhanced feedback loop) resulted in a significant increase in HH compliance (69.5% in the enhanced group vs 59.1% in the basic group; P = .0001). Conclusion: An enhanced feedback loop system connected to invasive devices, providing real-time alerts to HCWs, is effective in improving HH compliance.

Comparing human to electronic observers to monitor hand hygiene compliance in an intensive care unit

“…10 Electronic HH monitoring systems are promising, but more research is needed for adequate validation. [33][34][35][36][37] In conclusion, the electronic HH system (electronic observer) used in this study had good correlation with the direct observation method (human observer), producing similar HH compliance rates with good accuracy. However, this electronic system has the potential to produce more realistic HH compliance rates by minimizing the Hawthorne effect.…”

Effects of the Implementation of Intelligent Technology for Hand Hygiene in Hospitals: Systematic Review and Meta-analysis

“…A total of 29 of the 33 included studies reported on HHC. A random-effects model was performed because of the significant heterogeneity for this outcome (I 2 =100%, P<.001; Figure 2) [15,19,21,[30][31][32][33][34][35][36][37][38][39][40][41][43][44][45]47,49,[51][52][53][54][56][57][58][59]62]. The pooled risk ratio (RR) of HHC was 1.56 (95% CI 1.47-1.66, P<.001; Figure 2).…”

“…Using the GRADE summary of evidence, the quality of evidence was very low and downgraded for indirectness, high risk of bias, and imprecision. [14] .10 0.71 (0.47-1.07) 5 Remove Liu [36] .04 0.47 (0.23-0.97) 5 Remove Marra [38] .20 0.49 (0.16-1.46) 5 Remove Shao [45] .09 0.54 (0.26-1.10) 5 Remove Sun [46] .04 0.45 (0.21-0.97) 5 Remove Xu [13] a OR: odds ratio.…”

Comparação de dois sistemas eletrônicos de higiene das mãos usando feedback em tempo real via tecnologia sem fio para melhorar a adesão à higiene das mãos em uma unidade de terapia intensiva

“…A figura 1 mostra a sequência de etapas para detecção da higiene das mãos pelos profissionais da saúde: Invasive device sensor connection to the IV bag on a pump; p. 4. (25) Figura 5. Conexão do sensor do dispositivo invasivo à bolsa em uma bomba de infusão…”

“…Fig.2. Differences between the devices installed in the ICU rooms; p. 3 (25). Comparison of two electronic hand hygiene systems using real-time feedback via wireless technology to improve hand hygiene compliance in an intensive care unitGeneroso, Casaroto, Serpa Neto, Prado, Gagliardi, de Menezes, Gonçalves, Hohmann, Olivato, Gonçalves, Pereira, Xavier, Miguel, Victor, Edmond, Marra.…”