title: An automated hand hygiene compliance system is associated with improved monitoring of hand hygiene.
abstract: BACKGROUND
  Consistent hand hygiene is key to reducing health care-associated infections (HAIs) and assessing compliance with hand hygiene protocols is vital for hospital infection control staff. A new automated hand hygiene compliance system (HHCS) was trialed as an alternative to human observers in an intensive care unit and an intensive care stepdown unit at a hospital facility in the northeastern United States.
  
  
  METHODS
  Using a retrospective cohort design, researchers investigated whether implementation of the HHCS resulted in improved hand hygiene compliance and a reduction in common HAI rates. Pearson χ2tests were used to assess changes in compliance, and incidence rate ratios were used to test for significant differences in infection rates.
  
  
  RESULTS
  During the study period, the HHCS collected many more hand hygiene events compared with human observers (632,404 vs 480) and ensured that the hospital met its compliance goals (95%+). Although decreases in multidrug-resistant organisms, central line-associated bloodstream infections, and catheter-associated urinary tract infection rates were observed, they represented nonsignificant differences.
  
  
  CONCLUSIONS
  Human hand hygiene observers may not report accurate measures of compliance. The HHCS is a promising new tool for fine-grained assessment of hand hygiene compliance. Further study is needed to examine the association between the HHCS and HAI rate reduction.
authors.affiliation: White Plains Hospital, White Plains, NY. Electronic address: smccalla@wphospital.org.
authors.forename: Saungi
authors.initials: S
authors.lastname: McCalla
authors.affiliation: White Plains Hospital, White Plains, NY.
authors.forename: Maggie
authors.initials: M
authors.lastname: Reilly
authors.affiliation: White Plains Hospital, White Plains, NY.
authors.forename: Rowena
authors.initials: R
authors.lastname: Thomas
authors.affiliation: White Plains Hospital, White Plains, NY.
authors.forename: Dawn
authors.initials: D
authors.lastname: McSpedon-Rai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation / Q000379:methods; D001521:Behavior Therapy / Q000379:methods*; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D055815:Young Adult
keywords: Catheter-associated urinary tract infections; Central-line associated bloodstream infections; Multidrug-resistant organisms