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Success with Technology to Increase Hand Hygiene Compliance
Poster Abstracts / American Journal of Infection Control 41 (2013) S25-S145
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providers in adult, pediatric, and neonatal intensive care units (table 1). LESSON LEARNED: Communication and cooperation among healthcare workers was an essential key in problem solving and served to increase both staff and patient safety and increase the knowledge and comfort level with the infection control practices and guidelines. The process was driven by front line care providers and as such led to immediate uptake and likely improved adherence.
Presentation Number 5-310 Success with Technology to Increase Hand Hygiene Compliance Joan E. Wofford DNP, CRNP, ACNP-BC, Coordinator Cardiac Service Line/CRNP, Huntsville Hospital
coded, with each color representing a common pathogen requiring isolation. Such a system allowed us to maintain patient confidentiality. Pocket references explaining the coding system, as well as cards that would adhere to personal identification badges were provided to care providers. Bright colors were selected to increase visibility (figures 1and 2). RESULTS: Color coded isolation sign were more noticeable and gave the healthcare worker immediate information regarding the reason for isolation. Staff was no longer required to reference the patient’s chart to discern the reason for isolation, which saved time. Housekeeping could immediately discern appropriate needs in cleaning and disinfection. Our rate of compliance with isolation precautions was maintained in the ninetieth percentile among care
ISSUE: Hand hygiene (HH) is widely accepted as the most effective means of reducing Healthcare Associated Infection (HAI) occurrence; yet, most studies show HH compliance rates for healthcare workers (HCW) are below 50%. This hospital understood the need for improved HH compliance to improve patient safety and quality. PROJECT: This 881 bed hospital worked with Proventix Systems, Inc. to install the nGage wireless HH monitoring system in a 25 bed medical-surgical unit. They monitored 9 soap dispensers, 41 alcohol based hand rub (sanitizer) dispensers and 60 employees including Nurses, Patient Care Technicians, Nurse Practitioners, Technicians, Clinical Instructors, and Executive Staff. HH solution dispensing, HH compliance, and HAI rates were measured and reported from December 2011 through January 2013. RESULTS: During the first eight months of service, there was a 48.7% increase in total HH solution dispensing. These positive results contributed to a 40.7% increase in HH compliance. In August 2012, leadership increased their involvement, set unit level goals and began an employee education, communication and accountability campaign. Caregiver communications included open posting of individual compliance rates and a five-team interunit competition. HCWs also engaged and educated patients and their families about the importance of hand hygiene compliance. After the communication campaign, they noted a 90.4% increase in hand hygiene solution dispensing, and a 99.2% improvement in hand hygiene compliance. During this same time frame, individual HH compliance rate increases for the employees were statistically significant (Student’s t-test, paired t ¼ 9.507564 (40), p ¼ 2.9452E-15, SAS). In June of 2012, when benchmarked against other medical surgical units, this unit ranked 14th among 28 other medical surgical units. In January 2013, after the communication and engagement campaign, the unit had improved to a ranking of 1st among 34 other medical surgical units. When comparing first and last months of monitoring (December 2011-January 2013) dispensing increased by 173.6%, and HH compliance increased by 236.7%. HAIs decreased by 18.8% resulting in a direct cost savings of $112,164, a bottom line impact of $62,472, and 97.44 days length of stay avoided. LESSONS LEARNED: The Hospital initial improvements after implementation of the electronic HH monitoring system was further improved with increased leadership involvement, clear goal-setting, and the initiation of a caregiver education, communication and incentive program. The combination of these elements increased HH performance and resulted in improved clinical and financial outcomes.
APIC 40th Annual Conference j Ft Lauderdale, FL j June 8-10, 2013
S61
providers in adult, pediatric, and neonatal intensive care units (table 1). LESSON LEARNED: Communication and cooperation among healthcare workers was an essential key in problem solving and served to increase both staff and patient safety and increase the knowledge and comfort level with the infection control practices and guidelines. The process was driven by front line care providers and as such led to immediate uptake and likely improved adherence.
Presentation Number 5-310 Success with Technology to Increase Hand Hygiene Compliance Joan E. Wofford DNP, CRNP, ACNP-BC, Coordinator Cardiac Service Line/CRNP, Huntsville Hospital
coded, with each color representing a common pathogen requiring isolation. Such a system allowed us to maintain patient confidentiality. Pocket references explaining the coding system, as well as cards that would adhere to personal identification badges were provided to care providers. Bright colors were selected to increase visibility (figures 1and 2). RESULTS: Color coded isolation sign were more noticeable and gave the healthcare worker immediate information regarding the reason for isolation. Staff was no longer required to reference the patient’s chart to discern the reason for isolation, which saved time. Housekeeping could immediately discern appropriate needs in cleaning and disinfection. Our rate of compliance with isolation precautions was maintained in the ninetieth percentile among care
ISSUE: Hand hygiene (HH) is widely accepted as the most effective means of reducing Healthcare Associated Infection (HAI) occurrence; yet, most studies show HH compliance rates for healthcare workers (HCW) are below 50%. This hospital understood the need for improved HH compliance to improve patient safety and quality. PROJECT: This 881 bed hospital worked with Proventix Systems, Inc. to install the nGage wireless HH monitoring system in a 25 bed medical-surgical unit. They monitored 9 soap dispensers, 41 alcohol based hand rub (sanitizer) dispensers and 60 employees including Nurses, Patient Care Technicians, Nurse Practitioners, Technicians, Clinical Instructors, and Executive Staff. HH solution dispensing, HH compliance, and HAI rates were measured and reported from December 2011 through January 2013. RESULTS: During the first eight months of service, there was a 48.7% increase in total HH solution dispensing. These positive results contributed to a 40.7% increase in HH compliance. In August 2012, leadership increased their involvement, set unit level goals and began an employee education, communication and accountability campaign. Caregiver communications included open posting of individual compliance rates and a five-team interunit competition. HCWs also engaged and educated patients and their families about the importance of hand hygiene compliance. After the communication campaign, they noted a 90.4% increase in hand hygiene solution dispensing, and a 99.2% improvement in hand hygiene compliance. During this same time frame, individual HH compliance rate increases for the employees were statistically significant (Student’s t-test, paired t ¼ 9.507564 (40), p ¼ 2.9452E-15, SAS). In June of 2012, when benchmarked against other medical surgical units, this unit ranked 14th among 28 other medical surgical units. In January 2013, after the communication and engagement campaign, the unit had improved to a ranking of 1st among 34 other medical surgical units. When comparing first and last months of monitoring (December 2011-January 2013) dispensing increased by 173.6%, and HH compliance increased by 236.7%. HAIs decreased by 18.8% resulting in a direct cost savings of $112,164, a bottom line impact of $62,472, and 97.44 days length of stay avoided. LESSONS LEARNED: The Hospital initial improvements after implementation of the electronic HH monitoring system was further improved with increased leadership involvement, clear goal-setting, and the initiation of a caregiver education, communication and incentive program. The combination of these elements increased HH performance and resulted in improved clinical and financial outcomes.
APIC 40th Annual Conference j Ft Lauderdale, FL j June 8-10, 2013