title: A Prospective Controlled Trial of an Electronic Hand Hygiene Reminder System.
abstract: Background.  The use of electronic hand hygiene reminder systems has been proposed as an approach to improve hand hygiene compliance among healthcare workers, although information on efficacy is limited. We prospectively assessed whether hand hygiene activities among healthcare workers could be increased using an electronic hand hygiene monitoring and reminder system. Methods.  A prospective controlled clinical trial was conducted in 2 medical intensive care units (ICUs) at an academic medical center with comparable patient populations, healthcare staff, and physical layout. Hand hygiene activity was monitored concurrently in both ICUs, and the reminder system was installed in the test ICU. The reminder system was tested during 3 administered phases including: room entry/exit chimes, display of real-time hand hygiene activity, and a combination of the 2. Results.  In the test ICU, the mean number of hand hygiene events increased from 1538 per day at baseline to 1911 per day (24% increase) with the use of a combination of room entry/exit chimes, real-time displays of hand hygiene activity, and manager reports (P < .001); in addition, the ratio of hand hygiene to room entry/exit events also increased from 26.1% to 36.6% (40% increase, P < .001). The performance returned to baseline (1473 hand hygiene events per day) during the follow-up phase. There was no significant change in hand hygiene activity in the control ICU during the course of the trial. Conclusions.  In an ICU setting, an electronic hand hygiene reminder system that provided real-time feedback on overall unit-wide hand hygiene performance significantly increased hand hygiene activity.
authors.affiliation: Division of Infectious Diseases and Immunology, Department of Medicine.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Ellison
authors.affiliation: Department of Quantitative Health Sciences , University of Massachusetts Medical School , Worcester ; Department of Biostatistics and Computational Biology , Dana-Farber Cancer Institute , Boston.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Barysauskas
authors.affiliation: Department of Computer Sciences , Worcester Polytechnic Institute , Massachusetts.
authors.forename: Elke A
authors.initials: EA
authors.lastname: Rundensteiner
authors.affiliation: Department of Computer Sciences , Worcester Polytechnic Institute , Massachusetts ; Microsoft Corporation , Redmond, Washington.
authors.forename: Di
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Quantitative Health Sciences , University of Massachusetts Medical School , Worcester.
authors.forename: Bruce
authors.initials: B
authors.lastname: Barton
keywords: electronic monitoring; hand hygiene; intensive care unit; prospective controlled trial