Levchenko Alexander I, Boscart Veronique M, Fernie Geoff R
Author Affiliations: Toronto Rehabilitation Institute, University Health Network, Toronto (Drs Levchenko and Fernie); Schegel Research Institute of Aging, University of Waterloo & Conestoga College, Kitchener (Dr Boscart); Department of Surgery, University of Toronto, Ontario, Canada (Dr Fernie).
Comput Inform Nurs. 2013 Oct;31(10):498-504. doi: 10.1097/01.NCN.0000432124.53902.1d.
Adequate hand hygiene compliance by healthcare staff is considered an effective method to reduce hospital-acquired infections. The electronic system developed at Toronto Rehabilitation Institute automatically detects hand hygiene opportunities and records hand hygiene actions. It includes an optional visual hand hygiene status indication, generates real-time hand hygiene prompting signals, and enables automated monitoring of individual and aggregated hand hygiene performance. The system was installed on a complex continuous care unit at the entrance to 17 patient rooms and a utility room. A total of 93 alcohol gel and soap dispensers were instrumented and 14 nurses were provided with the personal wearable electronic monitors. The study included three phases with the system operating in three different modes: (1) an inactive mode during the first phase when hand hygiene opportunities and hand hygiene actions were recorded but prompting and visual indication functions were disabled, (2) only hand hygiene status indicators were enabled during the second phase, and (3) both hand hygiene status and real-time hand hygiene prompting signals were enabled during the third phase. Data collection was performed automatically during all of the three phases. The system indicated significantly higher hand hygiene activity rates and compliance during the third phase, with both hand hygiene indication and real-time prompting functions enabled. To increase the efficacy of the technology, its use was supplemented with individual performance reviews of the automatically collected data.
医护人员充分遵守手部卫生规范被认为是减少医院获得性感染的有效方法。多伦多康复研究所开发的电子系统能自动检测手部卫生时机并记录手部卫生行为。它包括一个可选的手部卫生状态视觉指示，生成实时手部卫生提示信号，并能自动监测个人和总体的手部卫生表现。该系统安装在一个复杂的持续护理单元，位于17间病房和一间杂物间的入口处。总共93个酒精凝胶和肥皂分配器被安装了仪器，14名护士配备了个人可穿戴电子监测器。该研究包括三个阶段，系统以三种不同模式运行：（1）第一阶段为非活动模式，此时记录手部卫生时机和手部卫生行为，但提示和视觉指示功能禁用；（2）第二阶段仅启用手部卫生状态指示器；（3）第三阶段同时启用手部卫生状态和实时手部卫生提示信号。在所有三个阶段均自动进行数据收集。在第三阶段，启用了手部卫生指示和实时提示功能，系统显示手部卫生活动率和依从性显著更高。为提高该技术的功效，对自动收集的数据进行个人绩效评估以补充其使用。
