Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit.
BACKGROUND
Hand hygiene (HH) compliance among health care workers (HCWs) has been historically low and hampered by poor surveillance methods. This study evaluated the use of an electronic device to measure and impact HH compliance.


METHODS
The study is a prospective, interventional study in a 30-bed academic medical center hematology unit. Phase I of the study monitored baseline HH compliance, and phase II monitored HH compliance using automatic alerts. The primary outcome measure was HH compliance, and the secondary end point was nosocomial transmission of vancomycin-resistant Enterococcus (VRE).


RESULTS
Eight thousand two hundred thirty-five HH opportunities were measured during the study, with HH compliance improvement from 36.3% at baseline to 70.1% during phase II. The use of audible alerts improved HH compliance for both the day shift (odds ratio [OR], 3.6) and the night shift (OR, 5.9), as well as across rooms with higher HCW traffic (OR, 1.6) and lower HCW traffic (OR, 3.2).


CONCLUSIONS
Electronic devices can effectively monitor HH compliance among HCWs and facilitate improved adherence to guidelines. Electronic devices improve HH compliance regardless of time of day or room location. The development of innovative devices to improve HH is required to validate the long-term implications of this methodology.
Venkatesh
Arjun K
AK
Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. avenkatesh@md.northwestern.edu
Lankford
Mary G
MG
Rooney
Denise M
DM
Blachford
Todd
T
Watts
Charles M
CM
Noskin
Gary A
GA
D000046:Academic Medical Centers; D003428:Cross Infection / Q000517:prevention & control*; D016983:Enterococcus / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection; D017053:Infection Control / Q000379:methods*; D011446:Prospective Studies; D020713:Vancomycin Resistance