By Melissa Berrios, RN
Hands are a known vector for communicable disease, making hand hygiene an important consideration for infection control at all times—but particularly in the midst of a global health crisis like the one facing us today.
Since the start of the pandemic, countless health officials have emphasized the importance of good hand hygiene to slow the spread of SARS-CoV-2 (COVID-19). This is especially critical in healthcare facilities, where patients with the virus share space with some of our most vulnerable, non-infected populations, and where essential healthcare workers risk exposure due to the nature of their jobs.
Hand hygiene is often thought of as the single most important tool to help prevent transmission of bacteria and control respiratory outbreaks worldwide. But for hand washing to work, it must be practiced by a majority of the population, and attaining high levels of compliance in healthcare settings can be difficult.
Unlike COVID-19, this issue has a relatively simple solution: Automated hand hygiene monitoring devices hardwire best practices in staff, increase compliance with hospital policies, and mitigate the risks associated with healthcare-associated infections (HAI).
Electronic solutions to automate monitoring
Electronic hand hygiene solutions automate monitoring and track hand washing events using sensors mounted to or embedded in dispensers, canisters, pumps, and sinks. Healthcare administrators and infection preventionists (IP) can use this data to determine whether employees are complying with facility protocols. For example, automated monitoring can record whether an employee washes their hands after entering a patient room. Some systems can even provide a gentle reminder to an employee who has missed a compliance event.
Unlike manual hand hygiene monitoring methods, electronic monitoring is not prone to human error, manipulation, or the Hawthorne effect (when people change their behavior because they know they are being watched). Electronic monitoring also eliminates the need for training and scheduling manual observers, freeing up resources to invest in patient care. An electronic monitoring system is impartial; it lays bare the strengths and weaknesses of each unit so that IPs can evaluate workflow and identify strategies for improvement.
The healthcare marketplace offers multiple automated monitoring solutions with a variety of features and price points. The most advanced systems only record a hand washing event when a dispenser is used in the presence of a staff badge. This increases data accuracy because the system only detects hand washing events by staff members and disregards those by patients and visitors. It also ensures the system only records an event when a staff member uses a dispenser, as opposed to pausing in front of one or passing one by.
Actionable reports to drive compliance
After sensors from electronic hand hygiene solutions record hand washing data, that data is compiled into actionable reports to improve hand hygiene compliance. An independent 2016 study conducted by three healthcare systems found that using CenTrak’s hand hygiene monitoring solutions boosted compliance rates by 45%.
Healthcare administrators and IPs use these reports to audit hand hygiene events across their facilities and identify trends—including if and when departments, groups, and even individuals are falling short in terms of compliance. Trends can also help healthcare leaders determine how to address shortcomings, like the adoption of a hand hygiene educational campaign, changing a policy or protocol, or rewarding units that are performing exceptionally well. It takes a sustained and multifaceted effort to modify habits—whether they relate to hand hygiene or otherwise—and the highest levels of hand hygiene compliance are reached when hand washing becomes ingrained.
Several accrediting organizations have recently increased their hand hygiene auditing requirements, and The Joint Commission has started urging healthcare administrators to invest in electronic hand hygiene monitoring. Leapfrog Group, for example, has increased its auditing requirement to at least 200 observations a month, which will require hospitals and ambulatory surgery centers without electronic systems to dedicate a substantial amount of manpower to data collection. Facilities that embrace this technology now will find it easier to produce more complete reports and likely achieve higher scores during future accreditation visits.
Healthcare leaders who wish to make the most of their hand hygiene investments can integrate them with other enterprise location, sensing, and security services. Like automated monitoring, these solutions use sensors to track aspects of healthcare operations in real time, including contact tracing, nurse call automation, asset management, and emergency alerts. And like hand hygiene monitoring, many of them can help healthcare facilities address circumstances caused by the pandemic.
HAIs: A risk to revenue and care
Healthcare systems everywhere are currently battling a second or third wave of COVID-19 outbreaks while still struggling with the effects of the first. In addition to treating patients suffering from COVID-19, healthcare facilities are faced with the daunting, unenviable task of containing the disease to protect non-infected patients, staff, and visitors.
Prior to the pandemic, multidrug-resistant organisms (MDRO) were identified as a global threat by the World Health Organization. HAIs also pose a serious threat to patient safety worldwide, causing 98,000 deaths per year in the U.S. alone. With the onset of COVID-19, the risk of HAIs and MDROs has only grown. Of course, the pandemic is not only a risk to patient safety—between March and June 2020, the healthcare industry took a substantial financial blow, totaling more than $200 billion in expenses and lost revenue. A separate study predicted healthcare facilities would face an additional $20.1 billion in losses per month through the end of 2020.
There is currently no clear understanding of who will pay for treatment if a patient were to acquire COVID-19 at a hospital. HAIs are not covered by insurance companies, and there is little reason to assume a hospital would get reimbursement if they were the vector for the disease. By investing in automated monitoring to improve hand hygiene compliance, healthcare leaders are investing in the quality of their care and the safety of patients, visitors, and staff. As an added benefit, by reducing HAIs, automated monitoring solutions can alleviate the financial burden of the pandemic and support the healthcare industry’s financial recovery.
Melissa Berrios, RN, BSN, is a clinical educator at CenTrak, a leader in locating, sensing, and security solutions for the healthcare industry.