The gold standard for measuring hand hygiene compliance, direct observation, is under fire, ContagionLive reports.
Here's what you need to know.
1. When it concerns hand hygiene, direct observation is a very limited practice. Observers can only examine a portion of all hand hygiene behaviors, and the incidences they do observe are not enough to make a statistically significant judgement.
2. If a hospital or center uses DO and believes it has a near perfect score, efforts to combat healthcare-associated infections are usually weakened because of a lack of urgency to improve.
3. Electronic systems are one way to combat this. The systems capture all hand hygiene events 24/7.
4. Hand hygiene should also follow the World Health Organization's Five Moments. Healthcare workers should wash their hands before contact with a patient, before an aseptic task, after body fluid exposure risk, after contact with a patient and after contact with a patient's surroundings.
5. By having accurate numbers, an organization can begin implementing quality practices.
6. In a study in the American Journal of Infection Control, Greenville Health Systems investigated how data from a compliance system which utilized the Five Moments impacted compliance. The study measured the occurrence rate of hospital-onset Methicillin-resistant Staphylococcus aureus infections after the Five Moments program began. Through 33 months, compliance rates increased 25.5 percent and MRSA HAI rates decreased 42 percent. The hospital also saved $434,000 in MRSA care costs.
7. ContagionLive indicates several best practices have emerged when implementing electronic hand hygiene technology. They include:
- Educate staff on how the technology works and its benefits versus DO to secure their buy-in before the technology is implemented.
- Ensure leadership is 100 percent engaged and behind the initiative, and communicates the importance of the Five Moments for Hand Hygiene compliance measurement.
- Transition from measuring hand hygiene compliance based on the “in and out” method to the Five Moments for Hand Hygiene guidelines.
- Educate and train staff on the unit level and allow units to set their own hand hygiene compliance goals.
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