Monitoring Pharmacy Student Adherence to World Health Organization Hand Hygiene Indications Using Radio Frequency Identification

Abstract

Objective. To assess and improve student adherence to hand hygiene indications using radio frequency identification (RFID) enabled hand hygiene stations and performance report cards. Design. Students volunteered to wear RFID-enabled hospital employee nametags to monitor their adherence to hand-hygiene indications. After training in World Health Organization (WHO) hand hygiene methods and indications, student were instructed to treat the classroom as a patient care area. Report cards illustrating individual performance were distributed via e-mail to students at the middle and end of each 5-day observation period. Students were eligible for individual and team prizes consisting of Starbucks gift cards in $5 increments. Assessment. A hand hygiene station with an RFID reader and dispensing sensor recorded the nametag nearest to the station at the time of use. Mean frequency of use per student was 5.41 (range: 2-10). Distance between the student's seat and the dispenser was the only variable significantly associated with adherence. Student satisfaction with the system was assessed by a self-administered survey at the end of the study. Most students reported that the system increased their motivation to perform hand hygiene as indicated. Conclusion. The RFID-enabled hand hygiene system and benchmarking reports with performance incentives was feasible, reliable, and affordable. Future studies should record video to monitor adherence to the WHO 8-step technique.Keywords: Infection control, radio frequency identification, architectural intentional design, pharmacy practice, hand hygiene, benchmarking, pay for performance, World Health Organization INTRODUCTIONHand hygiene is the single most effective method for preventing transmission of health care associated infections, a top-10 cause of death in the United States. 1,2Yet, fewer than half of providers comply with handhygiene indications and methods.3 Pharmacy students on practice experiences may be exposed to pathogens in health care settings through touching patient bedrails, curtains and tables in health systems or handling credit cards and shaking hands with patients in community settings. Despite the relevance to pharmacy practice and education, to the best of our knowledge, few studies have shed light on instruction and assessment methods for formal hand hygiene instruction in colleges and schools of pharmacy.Thirteen federal agencies, including the Food and Drug Administration (FDA), US Centers for Disease Control (CDC), and the National Institutes of Health (NIH), compose the Interagency Task Force on Antimicrobial Resistance. The task force endorses the World Health Organization (WHO) hand hygiene indications and methods for hand rubbing with alcohol-based products and has partnered with more than 2500 health care systems to implement these standards, including the use of "innovative and inexpensive wireless technologies to monitor healthcare worker movement and approximate hand hygiene adherence." 1 One of these technologies is radio frequency identification (...

Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology

“…Most studies (50/89, 56%) recruited HCWs from hospitals or clinics [ 29 , 30 , 32 - 40 , 44 , 46 - 57 , 59 , 61 , 66 - 68 , 73 - 75 , 77 - 80 , 82 , 84 , 86 , 87 , 89 - 91 , 95 , 96 , 98 - 100 , 103 , 106 ], and few (2/89, 2%) studies also involved patients from hospitals [ 66 , 94 ]. The remaining studies recruited the general public (7/89, 8%) [ 45 , 60 , 64 , 65 , 109 - 111 ] or students (4/89, 4%) [ 76 , 104 , 114 , 115 ] from communities or educational settings.…”

“…Of the 32 studies, 10 (31%) developed or deployed an RFID-based RTLS [ 71 , 73 , 75 , 76 , 83 , 84 , 90 , 93 , 97 , 99 ]. RFID uses radio waves to identify and track tags attached to objects.…”

“…When HCWs with RFID tags pass RFID readers, the readers detect the HCWs’ tags and then communicate the collected information to a central server. To record HCWs’ hand hygiene events, 30% (3/10) of studies placed RFID readers either next to dispensers or embedded RFID readers into dispensers [ 71 , 76 , 93 ], and these RFID readers were activated by dispensing events. By installing RFID readers next to dispensers and at the entrance of patient rooms or around patient beds, RFID-based RTLS could recognize both hand hygiene events and the entry and exit of individuals into a patient room or a patient area [ 73 , 75 , 83 , 84 , 90 , 99 ].…”

Prevention of Clostridium difficile Infection in Critically Ill Adults

“…Emphasis should also be placed on the appropriate hand hygiene method, understanding that soap‐and‐water hand hygiene should be used when caring for patients with CDI during outbreaks or in hyperendemic settings . Pharmacy personnel can be key team members of a hand hygiene program in the ICU and demonstrate adherence during clinical rounds, medication reconciliation, care conferences, medication delivery, and medical emergencies . Pharmacists can also be champions for hand hygiene in the ICU by promoting adherence to interdisciplinary staff participating in metric‐based feedback …”

Promoting Patient Safety Through Interprofessional Education Simulation

“…The 2013 National Quality Strategy to reduce HAIs has drawn increased attention to HH practices. 7,8 Implementation of the WHO recommendations for HH in healthcare workers has been successful with regards to compliance, especially in nurses. 9 Minimal published information is found on HH practice and instruction of CLS healthcare workers and CLS students' education.…”