Influence of the Internet of Things management system on hand hygiene compliance in an emergency intensive care unit

Abstract

Background: Hand hygiene is a critical strategy for infection prevention in all healthcare settings. Automated electronic monitoring systems are expected to improve hand hygiene performance. Aim: To investigate the impact of the Internet of Things (IoT) management system on hand hygiene compliance among medical staff in an emergency intensive care unit (EICU). Methods: This retrospective observational study was conducted between July 1 st , 2017 and February 28 th , 2018 in a 19-bed EICU. The changes in hand hygiene compliance among 54 members of medical staff and the incidence of hospital infections were compared, counted, and analysed before and after implementing the IoT management system in the EICU that was initiated on November 1 st , 2017. Findings: After the application of the IoT management system, the hand hygiene compliance rates among the members of the medical staff before (29.5% (3347/11,338) vs 57.9% (4690/8094), P < 0.001) and after (59.9% (9915/16,556) vs 73.8% (17,194/23 286), P < 0.001) the contact with patients and surrounding environment significantly improved. However, hand hygiene compliance among three cleaning staff did not significantly improve after the application. Moreover, there was no significant difference in healthcareacquired infection rates (2.535% (9/355) vs 2.047% (7/342), P ¼ 0.667) nor in the detection rates of the four major multidrug-resistant bacteria in the EICU before and after the application of the IoT management system (P > 0.05). Conclusion:The IoT management system significantly improved hand hygiene compliance among medical staff, except cleaners, in the EICU of one provincial hospital; however, the rates of nosocomial infection did not significantly decrease. The quality of hand hygiene implementation needs to be improved.

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

“…We identified 16,791 articles and reviewed 8571 unique titles and abstracts (after removing duplicates across databases) and 440 full-text articles, with 36 studies meeting the predefined eligibility criteria [ 15 , 20 , 22 , 23 , 30 - 61 ]. Study characteristics related to the population, interventions, and outcomes for the 36 included studies are provided in Table S2 in Multimedia Appendix 2 [ 15 , 19 , 21 , 22 , 30 - 60 , 62 ]. The 36 unique articles included 2 (6%) RCTs [ 53 , 54 ] and 34 (94%) quasi-experimental studies [ 15 , 19 , 21 , 22 , 30 - 52 , 55 - 60 , 62 ] (8 non-RCTs and 26 one-group pretest-posttest quasi-experimental designs).…”

“…Study characteristics related to the population, interventions, and outcomes for the 36 included studies are provided in Table S2 in Multimedia Appendix 2 [ 15 , 19 , 21 , 22 , 30 - 60 , 62 ]. The 36 unique articles included 2 (6%) RCTs [ 53 , 54 ] and 34 (94%) quasi-experimental studies [ 15 , 19 , 21 , 22 , 30 - 52 , 55 - 60 , 62 ] (8 non-RCTs and 26 one-group pretest-posttest quasi-experimental designs). Studies were published between 2013 and 2022, apart from 2 studies published in 2008 [ 48 , 58 ].…”

“…Although studies have investigated the effectiveness of different intelligent technologies for hand hygiene in hospitals, to the best of our knowledge, only 2 reviews were attempted to summarize the evidence resulting from these studies [ 11 , 20 ]. However, the findings of intelligent technology effects were inconsistent or even contradictory among different studies, and most previous studies only focused on the impacts of intelligent technology on HHC [ 21 , 22 ]. As such, we reviewed the literature and conducted a systematic review and meta-analysis to ascertain the effects of intelligent technology interventions on clinical and process outcomes.…”

Internet of things in healthcare for patient safety: an empirical study

“…In another retrospective study, Xu et al (2021) measured the effectiveness of an IoT-based management system on HH compliance in an intensive care unit. They found that the new system increased the HH compliance rate among all staff aside from the cleaners [43]. Similarly, in another study, an IoT-based automatic monitoring system was implemented to collect real-time data and employ gamification to improve HH compliance among nurses in both simulation and clinical environments.…”

Smart Hand Sanitisers in the Workplace: A Survey of Attitudes towards an Internet of Things Technology

“…Given the recognised importance of hand hygiene in clinical settings, it is not surprising that hospitals were early adopters of technologies that could monitor HH activity [ 18 ]. Despite their lack of sophistication, early Smart devices proved effective in improving hand hygiene compliance [ 19 , 20 , 21 ]. Significant further developments were made possible by the growing acceptance of alcohol-based sanitising gel as an effective alternative to soap and water [ 22 ].…”