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Hand Hygiene Monitoring System Detects Soap, Alcohol Use

News  |  By HealthLeaders Media News  
   August 30, 2016

Sensors being tested in two Emory University hospitals track handwashing, provide feedback to healthcare workers, and report overall compliance rates.

Two Emory hospitals are applying sensor technologies in the continuous push to improve hand hygiene compliance among healthcare workers.


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A CDC-funded study underway at Emory University Hospital Midtown (EUHM) and Emory Johns Creek Hospital (EJCH), are testing a monitoring system to measure hand hygiene compliance.

Data is collected by electronic sensors attached to alcohol hand-rub and soap dispensers in patient rooms and hallways at the two hospitals.

At EUHM, an urban teaching hospital in Atlanta, GA, the sensors are located in five adult ICUs and on two other floors. At EJCH, a smaller community hospital in Johns Creek, GA, the monitoring units have been installed in one ICU and on one medical floor.

Healthcare workers participating in the study wear badges equipped with Bluetooth technology to communicate with the sensors, which can detect when badge-wearing study participants are nearby, and can detect whether alcohol or soap has been used.

In addition, sensors in patient rooms use ultrasound to detect if badged or non-badged persons enter or leave the room, and simultaneously monitor for hand hygiene compliance.

In some stages of the study, a voice reminder will sound if a healthcare worker enters a room and doesn't clean his or her hands.

The researchers will compare the efficacy of different types of feedback to employees on how reliably they clean their hands.


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"The purpose of this project is to look for cues to remind us what we need to do to make ourselves the best we can be when it comes to hand hygiene,"  Marcia Postal-Ranney, RN, manager of infection prevention at EJHC, said in a statement.

The Emory study of the relative effectiveness of cues is similar to work being done at the Perelman School of Medicine at the University of Pennsylvania, which is testing ways "nudges" can be used to optimize medical decisions and improve the value of care.

Initially, the units involved in the Emory study will receive reports of overall compliance rates. Other strategies will be used later in the study, including immediate voice feedback on room entry and individual employee compliance for those using the study badges.

Different voice reminders will be tested, as will combinations of feedback methods.

In addition, researchers will survey participants' attitudes and beliefs about hand hygiene, being monitored, and hearing voice reminders.

Emory Healthcare's hand hygiene rates are roughly 60% according to trained anonymous observers, based on only 20 observations logged per month for each unit, according to James Steinberg, MD, co-principal investigator of the study.

In contrast, an automated system could make "tens of thousands" of observations per month, Steinberg said in a statement.

Emory's hand hygiene compliance rate is similar to that reported in a recent study, published in the American Journal of Infection Control. That study determined that staff at 15 New Mexico outpatient care facilities failed to wash their hands 37% of the time.

"Our goal is to determine if providing individual compliance rates and immediate feedback with various voice reminders will produce an increase of hand hygiene more effectively than either intervention alone."


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