Hand hygiene (HH) compliance is widely recognized as an essential factor in preventing healthcare-acquired infections (HAIs). However, hand hygiene compliance is inconsistent at best. Estimates of overall HH compliance in the U.S. range from 26% to over 75%. In other words, no one knows for sure what is the real hand hygiene compliance rate .
Two recent announcements may hold hope for reducing HAIs:
A study of HAIs in a pediatric units, recently published in Pediatrics, indicates that mandatory gloving of clinicians may reduce the risk of HAIs. Between 2002 and 2010, the researchers from the University of Iowa compared HAIs during periods where mandatory gloving policies were in effect with other periods when gloving was not required. They found that the risk of HAIs was 25% lower during mandatory gloving periods, and thus, that the results suggest a potential clinical benefit for universal gloving in acute care pediatric units.
Addressing the hand hygiene compliance issue, as discussed in the December 13, 2012 installment of this blog, requires a combination of training, education, system change, workplace reminders, monitoring, and institutional culture changes.
A system introduced by a company called IntelligentM at the TEDMED conference last week claims to simplify the reminders and monitoring factors. The core of their system is a wristband (called a smartband) that interacts with RFID and Bluetooth tags on hand sanitizers, soap dispensers, and medical equipment and products.
The wristband will issue a vibrating reminder if the clinician approaches catheter packaging, for example, without having performed hand hygiene first, or when proper protocols have not been followed. The system can also report compliance data to the administrative department on an individual clinician or aggregated department or location basis.
Both of these measures—mandatory gloving and wristband monitoring systems—sound expensive and difficult to implement. However, the comparative cost in dollars or in patient consequences are likely to make these measures seem much more accessible.
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Why do we so frequently use the term “multifaceted approach” when we talk about what’s required to address the problem of healthcare associated infections (HAIs)? Here’s one reason: hand hygiene is widely acknowledged as an essential element of any HAI control program, and hand hygiene compliance rates vary widely among medical personnel, let alone hospital visitors.