title: Assessment of an Aggregate-Level Hand Hygiene Monitoring Technology for Measuring Hand Hygiene Performance Among Healthcare Personnel.
abstract: BACKGROUND Despite significant advances in technological methods for hand hygiene surveillance, a lack of evidence prohibits comparison of systems to one another or against the current gold standard of direct observation. OBJECTIVE To validate a hand hygiene monitoring technology (HHMT) designed to capture hand hygiene behaviors aggregated at the hospital-unit level (GOJO Industries, Akron, OH). METHODS Our team followed a rigorous validation approach to assess the sensitivity and positive predictive value (PPV) of an HHMT. A planned path was first used to measure the accuracy of the system when purposefully activated by investigators. Next, behavioral validation was used to quantify accuracy of the system in capturing real-world behaviors. RESULTS During the planned path phase, investigators performed 4,872 unique events across 3 distinct hospital buildings varying in size and age since construction. Overall sensitivity across the medical center was 88.7% with a PPV of 99.2%. During the behavioral validation phase, trained direct observers recorded 5,539 unique events across 3 distinct hospital buildings. Overall sensitivity across the medical center was 92.7% and PPV was 84.4%. CONCLUSION Objective measures of sensitivity and PPV indicate the promise of the benefit of this and other HHMTs to capture basic behaviors associated with hand hygiene. Infect Control Hosp Epidemiol 2017;38:348-352.
authors.affiliation: 1University of Chicago Medicine,Center for Healthcare Delivery Science and Innovation,Chicago,Illinois.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Limper
authors.affiliation: 3University of Chicago Medicine,Infection Control Program,Chicago,Illinois.
authors.forename: Lynn
authors.initials: L
authors.lastname: Slawsky
authors.affiliation: 3University of Chicago Medicine,Infection Control Program,Chicago,Illinois.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Garcia-Houchins
authors.affiliation: 2University of Illinois at Chicago,School of Public Health,Division of Epidemiology and Biostatistics,Chicago,Illinois.
authors.forename: Supriya
authors.initials: S
authors.lastname: Mehta
authors.affiliation: 2University of Illinois at Chicago,School of Public Health,Division of Epidemiology and Biostatistics,Chicago,Illinois.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.affiliation: 1University of Chicago Medicine,Center for Healthcare Delivery Science and Innovation,Chicago,Illinois.
authors.forename: Emily
authors.initials: E
authors.lastname: Landon
mesh_terms: D002641:Chicago; D019983:Guideline Adherence; D063373:Hand Hygiene; D006282:Health Personnel; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity