Comparison of two electronic hand hygiene systems using real-time feedback via wireless technology to improve hand hygiene compliance in an intensive care unit

José R Generoso Jr; Eduardo Casaroto; Ary Serpa Neto; Marcelo Prado; Guilherme M Gagliardi; Fernando Gatti de Menezes; Priscila Gonçalves; Fábio Barlem Hohmann; Guilherme Benfatti Olivato; Gustavo Potratz Gonçalves; Andréa Marques Pereira; Nathalia Xavier; Marcelo Fernandes Miguel; Elivane da Silva Victor; Michael B Edmond; Alexandre R Marra

doi:10.1017/ash.2022.270

Comparison of two electronic hand hygiene systems using real-time feedback via wireless technology to improve hand hygiene compliance in an intensive care unit

Antimicrob Steward Healthc Epidemiol. 2022 Jul 25;2(1):e127. doi: 10.1017/ash.2022.270. eCollection 2022.

Authors

José R Generoso Jr¹, Eduardo Casaroto¹, Ary Serpa Neto^{1

2}, Marcelo Prado³, Guilherme M Gagliardi³, Fernando Gatti de Menezes⁴, Priscila Gonçalves⁴, Fábio Barlem Hohmann¹, Guilherme Benfatti Olivato¹, Gustavo Potratz Gonçalves¹, Andréa Marques Pereira¹, Nathalia Xavier¹, Marcelo Fernandes Miguel¹, Elivane da Silva Victor¹, Michael B Edmond⁵, Alexandre R Marra^{1

6}

Affiliations

¹ Instituto Israelita de Ensino e Pesquisa Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
² Monash University, ANZIC-RC, Melbourne, New South Wales, Australia.
³ Universidade de São Paulo, São Carlos, São Paulo, Brazil.
⁴ Infection Control Unit, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
⁵ West Virginia University School of Medicine, Morgantown, West Virginia, United States.
⁶ Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.

Abstract

Background: Most hand hygiene (HH) intervention studies use a quasi-experimental design, are primarily uncontrolled before-and-after studies, or are controlled before-and-after studies with a nonequivalent control group. Well-funded studies with improved designs and HH interventions are needed.

Objectives: To evaluate healthcare worker (HCW) HH compliance with alcohol-based hand rub (ABHR) through direct observation (human observer), 2 electronic technologies, a radio frequency identification (RFID) badge system, and an invasive device sensor.

Methods: In our controlled experimental study, 2,269 observations were made over a 6-month period from July 1 to December 30, 2020, in a 4-bed intensive care unit. We compared HH compliance between a basic feedback loop system with RFID badges and an enhanced feedback loop system that utilized sensors on invasive devices.

Results: Real-time feedback by wireless technology connected to a patient's invasive device (enhanced feedback loop) resulted in a significant increase in HH compliance (69.5% in the enhanced group vs 59.1% in the basic group; P = .0001).

Conclusion: An enhanced feedback loop system connected to invasive devices, providing real-time alerts to HCWs, is effective in improving HH compliance.