title: Effectiveness of an audible reminder on hand hygiene adherence.
abstract: BACKGROUND
  Multimodal interventions aim to improve health care workers' adherence to hand hygiene guidelines. Visitors are not primarily targeted, but may spread epidemic infections. Effective interventions that improve the adherence of visitors to hand hygiene guidelines are needed to prevent the transmission of epidemic infections to or from health care environments.
  
  
  METHODS
  An electronic motion sensor-triggered audible hand hygiene reminder was installed at hospital ward entrances. An 8-month preinterventional and postinterventional study was carried out to measure the adherence of hospital visitors and staff to hand hygiene guidelines.
  
  
  RESULTS
  Overall hand hygiene adherence increased from 7.6% to 49.9% (P < .001). The adherence of visitors and nonclinical staff increased immediately from 10.6% to 63.7% and from 5.3% to 34.8%, respectively (P < .001). Adherence of doctors, nurses, and physiotherapists increased gradually from 4.5% to 38.3%, from 5.4% to 43.4%, and from 8.7% to 49.5%, respectively (P < .001). Improved adherence was sustained among visitors and clinical staff (P < .001), but not among nonclinical staff (P = .341).
  
  
  CONCLUSIONS
  The electronic motion sensor-triggered audible reminder immediately and significantly improved and sustained greater adherence of hospital visitors and clinical staff to hand hygiene guidelines. This is an effective addition to multimodal hand hygiene interventions and may help control epidemic infections.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: Morkos
authors.initials: M
authors.lastname: Fakhry
authors.forename: George B
authors.initials: GB
authors.lastname: Hanna
authors.forename: Oliver
authors.initials: O
authors.lastname: Anderson
authors.forename: Alison
authors.initials: A
authors.lastname: Holmes
authors.forename: Dinesh
authors.initials: D
authors.lastname: Nathwani
mesh_terms: D019983:Guideline Adherence / Q000458:organization & administration / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000379:methods*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration; D017010:Reminder Systems / Q000295:instrumentation*; D014789:Visitors to Patients / Q000523:psychology*