Review of technologies available to improve hand hygiene compliance – are they fit for purpose?

Abstract

Hand hygiene has been empirically proven to prevent cross-transmission of infection, which has led to the development of global guidelines such as the World Health Organization’s ‘My 5 Moments for Hand Hygiene.’ Because of the relatively recent launch of these guidelines (2009) technology designed to assist in measuring hand hygiene compliance appears not to fully acknowledge the influence of the WHO 5 Moments for hand hygiene Consequently, they may not be fit for purpose (FFP). This paper uses a review of the literature on current hand hygiene technology to assess the extent to which these are FFP based on these global guidelines. The results show that there are a variety of technologies available to assist with the monitoring and measurement of hand hygiene levels. However, none appear to explicitly achieve detection of all WHO 5 Moments for hand hygiene, limiting their effectiveness. The authors conclude that a systems approach offers a potential aid for developers aspiring to meet domain specific FFP requirements. Human factors may help guide such developments to meet user and context specific needs.

Impact of observing hand hygiene in practice and research: a methodological reconsideration

“…If organisations can estimate non-clinical consumption, take into account uptake from individual dispensers and adjust their calculations, this approach could offer a useful alternative to direct observation but with loss of information: most systems do not monitor compliance for individual members of staff, professional groups, provide data on the hand hygiene event in relation to the sequence of patient care however 57 . Product could be used to identify clinical areas where hand hygiene appears to be problematic 9 , however.…”

“…Hand hygiene can be monitored with electronic and computerised devices that employ infra-red detection and wireless networks 57 . It has been argued that staff become habituated to presence of the device when they are used continuously, 58 and there is evidence that they can overcome the Hawthorne effect.…”

Investigating the use of an electronic hand hygiene monitoring and prompt device: influence and acceptability

“…Finally, with regard to reliability, the authors found the accuracy of systems variable. Dawson and Mackrill’s (2014) review also investigated the extent of coverage of systems and found that no available system was able to measure moments 2 and 3 (before and after a procedure). These authors cite Vicente (2006) and suggest, when developing optimal HH monitor and prompt systems, we need to: (1) understand what governs human behaviour and (2) understand how HCPs want to be monitored and the personal acceptance of technology.…”

Technology in the OR: AORN Members' Perceptions of the Effects on Workflow Efficiency and Quality Patient Care

“…The chip also reminded users if they did or did not wash their hands at appropriate times and locations, or a sensor chirped to remind the user to either wash his or her hands or use the hand sanitizer. Despite the promise of this type of technology, Dawson and Mackrill 12 concluded that none of the technologies monitored, measured, or provided feedback for all five stages at which hand hygiene should be performed, as identified by the World Health Organization 13 . The hand‐hygiene element was captured in the ATOR in item I.08 in the RFID section, to determine the use of monitoring technology relative to that topic.…”