Measuring Rates of Hand Hygiene Adherence in the Intensive Care Setting: A Comparative Study of Direct Observation, Product Usage, and Electronic Counting Devices

Abstract

Direct observation cannot be considered the gold standard for assessing hand hygiene, because there was no relationship between the observed adherence and the number of dispensing episodes or the volume of product used. Other means to monitor hand hygiene adherence, such as electronic devices and measurement of product usage, should be considered.

Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene

“…49 ' 25,53 and can be used to monitor trends in consumption over time or by type of care unit. 35,36,54 This can be as simple as tracking the amount of product used by individual units over time. Product usage can also be compared with the industry-average volume of a single dose of product in estimating adherence rates.…”

Measuring hand hygiene compliance rates in different special care settings: a comparative study of methodologies

“…This is a practical method with good acceptance. [5][6][7][8] Since the overall goal of measuring hand hygiene compliance is to change HCW behavior and improve the quality of care, it is necessary to give timely feedback to HCWs. This remains the biggest challenge for improving hand hygiene compliance.…”

Comparison of human and electronic observation for the measurement of compliance with hand hygiene

“…4 However, direct observation is generally able to capture only a very small fraction of hand hygiene opportunities. 5 Moreover, observers typically use relatively short observation periods 4,5 ; however, electronic counters record 24 hours per day. 2,3,5 It has been also demonstrated that directly observed rates of adherence may not be accurate because they do not correlate with other hand hygiene metrics (eg, electronic handwash counters).…”

“…5 Moreover, observers typically use relatively short observation periods 4,5 ; however, electronic counters record 24 hours per day. 2,3,5 It has been also demonstrated that directly observed rates of adherence may not be accurate because they do not correlate with other hand hygiene metrics (eg, electronic handwash counters). 2,5 Direct observation could change health care worker (HCW) behavior if the workers knew they are being observed.…”

“…2,3,5 It has been also demonstrated that directly observed rates of adherence may not be accurate because they do not correlate with other hand hygiene metrics (eg, electronic handwash counters). 2,5 Direct observation could change health care worker (HCW) behavior if the workers knew they are being observed. 2,6 These are reasons to search for other strategies to monitor hand hygiene compliance.…”