Cleanliness Sensors: Using Technology to Improve Hand Hygiene Compliance

This member-only article appears in the August issue of Patient Safety Monitor Journal.
Infection preventionist Jessica Strauch shares an amusing anecdote to show how hand hygiene monitoring technology has improved the culture at Lutheran Medical Center in Colorado.

Picture one of Lutheran’s nurses standing in front of her kitchen sink at home. Dinner is hot and ready, and the nurse stops to wash her hands before everyone digs in. Then, even though she is out of her scrubs and wearing civilian clothes, she waves her hands in front of an imaginary badge.

Oh, shoot, she isn’t at work anymore. But hey, at least the nurse remembered to wash her hands without a beep or a buzz from her BioVigil badge reminding her to perform hand hygiene.

“It’s funny to hear nurses say that,” says Strauch, chuckling.

Lutheran is among the healthcare organizations nationwide that in recent years decided to try hand hygiene monitoring technology in the hopes it could improve hand hygiene compliance—and in the process reduce the number of infections and avoid citations from accrediting organizations like The Joint Commission, which in January put stricter enforcement in place.

Previously, a healthcare organization wasn’t punished for individual hand hygiene failures if it had an otherwise compliant hand hygiene program. Now, if a Joint Commission surveyor sees an individual who directly cares for patients fail to perform required hand hygiene, the healthcare organization will receive an RFI under Infection Prevention and Control (IC) standard IC.02.01.01, element of performance 2, which requires organizations to use precautions such as hand hygiene to reduce infection risk.

“While there are various causes for HAI, The Joint Commission has determined that failure to perform hand hygiene associated with direct care of patients should no longer be one of them,” according to the December 2017 issue of Joint Commission’s Perspectives magazine.
Additionally, The Joint Commission requires that healthcare organizations meet National Patient Safety Goal (NPSG) 07.01.01, which requires them to implement and maintain a hand hygiene program.

The majority of U.S. hospitals and outpatient facilities do not currently use hand hygiene monitoring technology, though perhaps the increased surveyor focus on hand hygiene compliance and more success stories like Strauch’s will encourage others to pony up.
The cost can certainly be a turnoff for cost-conscious C-suite execs. Some employees will be concerned about nonstop surveillance, too. But research shows that, somehow, thousands and thousands of healthcare workers still don’t wash their hands as often as they should despite everything now known about the impact of hand hygiene on infection control. So, it makes sense for organizations that struggle with hand hygiene compliance to at least consider new technology.

“You hate to see a forcing function,” says Marge MacFarlane, PhD, MT(ASCP), CHSP, CHFM, HEM, MEP, CHEP, principal of Superior Performance in Eau Claire, Wisconsin. “But if you don’t have some kind of forcing function—whether they alarm you or your hands turn blue or your hair turns blue or whatever—I’m not sure if people will wash their hands the way they’re supposed to.”

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