Utility of electronic hand hygiene counting devices for measuring physicians' hand hygiene adherence applied to outpatient settings

作者：Arai Akie; Tanabe Masaki; Nakamura Akiko; Yamasaki Daisuke; Muraki Yuichi; Kaneko Toshihiro; Kadowaki Ayako; Ito Masaaki

来源：American Journal of Infection Control, 2016, 44(12): 1481-1485.

DOI：10.1016/j.ajic.2016.08.002

• Hand hygiene
• Compliance
• Electronic counting device
• Monitoring

Background: Our objectives were to evaluate the utility of electronic hand hygiene counting devices in outpatient settings and the impact of results feedback on physicians' hand hygiene behaviors.
Methods: We installed 130 electronic hand hygiene counting devices in our redesigned outpatient department. We remotely monitored physicians' hand hygiene practices during outpatient examinations and calculated the adherence rate as follows: number of hand hygiene counts divided by the number of outpatients examined multiplied by 100. Physician individual adherence rates were also classified into 4 categories.
Results: Two hundred and eighty physicians from 28 clinical departments were monitored for 3 months. The overall hand hygiene adherence rate was 10.7% at baseline, which improved significantly after feedback to 18.2% in the third month. Of the clinical departments, 78.6% demonstrated significant improvement in hand hygiene compliance. The change in the percentage of physicians in each category before and after feedback were as follows: very low (84.3% to 72.1%), low (8.6% to 14.3%), moderate (2.9% to 8.9%), and high (4.3% to 4.6%), from the first to third month, respectively. Based on category assessment, 17.1% of physicians were classified as responders.
Conclusions: Physicians' adherence to hand hygiene practices during outpatient examinations was successfully monitored remotely using electronic counting devices. Audit and feedback of adherence data may have a positive impact on physicians' hand hygiene compliance.