Improving Patient Safety With Hand Hygiene Compliance Monitoring

Abstract

Hand hygiene is important for patient safety; increasing hand hygiene compliance may reduce the frequency of healthcare-associated infections. This paper describes a distributed system that uses instrumented product dispensers and doorway monitors to systematically measure hand hygiene compliance as an alternative to compliance measurements by human observers, which is the current standard. The paper describes two experiments. The first experiment monitored 4,266 doorway crossings and 858 hand hygiene dispenser events for 4 patient rooms over 80 consecutive hours. The second experiment was part of a larger effort that included a direct comparison of a human observer with the automatically recorded observations. The results of the two experiments suggest that large quantities of data could be readily acquired, but the data was sensitive to several limitations not suffered by human observers including: distinguishing between single versus closely spaced multiple threshold crossings and distinguishing staff from patients and visitors. However, a direct comparison of human versus machine readings suggested that the system might overcome observational challenges faced by the human observers, providing more consistent and reliable measurements.