Implementation and Impact of an Automated Group Monitoring and Feedback System to Promote Hand Hygiene Among Health Care Personnel

摘要

Feedback of hand hygiene rates via an automated GMS was associated with minimally improved compliance in the short term. Despite limitations, this real-life field test of an automated GMS for hand hygiene provides detailed information for other facilities considering implementation. Reporting implementation "failures" in addition to "successes" can help others draw the appropriate lessons to plan more effective strategies before implementing their own interventions-in this case, hand hygiene electronic monitoring systems. A substantial investment of human capital is required to fully exploit the benefits of a GMS. A team of champions is likely needed to communicate information about the GMS, answer questions, engender confidence in the automated data, ensure consistent feedback to frontline staff, and optimize use of the data for improvement. Ongoing vendor support is needed to establish and maintain direct data feeds of census data. Leadership support and training in use of the data are essential to sustain gains in compliance. To achieve buy-in, HCP and managers accustomed to hand hygiene being monitored at room entry and exit should be trained in the WHO 5 Moments. Data reported as events per patient-hour or patient-visit may be as meaningful to HCP as an index; however, an index allows comparison across units with different patient acuities. Further research is needed to validate the number of times that hand hygiene can be expected in multiple settings with different patient populations.