title: Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare.
abstract: BACKGROUND
  Hand hygiene is a key measure in preventing infections. We evaluated healthcare worker (HCW) hand hygiene with the use of remote video auditing with and without feedback.
  
  
  METHODS
  The study was conducted in an 17-bed intensive care unit from June 2008 through June 2010. We placed cameras with views of every sink and hand sanitizer dispenser to record hand hygiene of HCWs. Sensors in doorways identified when an individual(s) entered/exited. When video auditors observed a HCW performing hand hygiene upon entering/exiting, they assigned a pass; if not, a fail was assigned. Hand hygiene was measured during a 16-week period of remote video auditing without feedback and a 91-week period with feedback of data. Performance feedback was continuously displayed on electronic boards mounted within the hallways, and summary reports were delivered to supervisors by electronic mail.
  
  
  RESULTS
  During the 16-week prefeedback period, hand hygiene rates were less than 10% (3933/60 542) and in the 16-week postfeedback period it was 81.6% (59 627/73 080). The increase was maintained through 75 weeks at 87.9% (262 826/298 860).
  
  
  CONCLUSIONS
  The data suggest that remote video auditing combined with feedback produced a significant and sustained improvement in hand hygiene.
authors: Department of Epidemiology, North Shore University Hospital, Manhasset, NY, USA.
authors: Donna
authors: D
authors: Armellino
authors: Erfan
authors: E
authors: Hussain
authors: Mary Ellen
authors: ME
authors: Schilling
authors: William
authors: W
authors: Senicola
authors: Ann
authors: A
authors: Eichorn
authors: Yosef
authors: Y
authors: Dlugacz
authors: Bruce F
authors: BF
authors: Farber
mesh_terms: D001521:Behavior Therapy; D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000379:methods*; D006282:Health Personnel; D006302:Health Services Research; D006801:Humans; D007362:Intensive Care Units; D008485:Medical Audit / Q000379:methods*; D014741:Video Recording / Q000379:methods*