Conway Laurie J, Riley Linda, Saiman Lisa, Cohen Bevin, Alper Paul, Larson Elaine L
Jt Comm J Qual Patient Saf. 2014 Sep;40(9):408-17. doi: 10.1016/s1553-7250(14)40053-9.
Despite substantial evidence to support the effectiveness of hand hygiene for preventing health care-associated infections, hand hygiene practice is often inadequate. Hand hygiene product dispensers that can electronically capture hand hygiene events have the potential to improve hand hygiene performance. A study on an automated group monitoring and feedback system was implemented from January 2012 through March 2013 at a 140-bed community hospital.
An electronic system that monitors the use of sanitizer and soap but does not identify individual health care personnel was used to calculate hand hygiene events per patient-hour for each of eight inpatient units and hand hygiene events per patient-visit for the six outpatient units. Hand hygiene was monitored but feedback was not provided during a six-month baseline period and three-month rollout period. During the rollout, focus groups were conducted to determine preferences for feedback frequency and format. During the six-month intervention period, graphical reports were e-mailed monthly to all managers and administrators, and focus groups were repeated.
After the feedback began, hand hygiene increased on average by 0.17 events/patient-hour in inpatient units (interquartile range = 0.14, p = .008). In outpatient units, hand hygiene performance did not change significantly. A variety of challenges were encountered, including obtaining accurate census and staffing data, engendering confidence in the system, disseminating information in the reports, and using the data to drive improvement.
Feedback via an automated system was associated with improved hand hygiene performance in the short-term.
尽管有大量证据支持手部卫生对于预防医疗保健相关感染的有效性，但手部卫生措施的落实往往并不充分。能够通过电子方式记录手部卫生事件的手部卫生产品分配器，有可能改善手部卫生执行情况。2012年1月至2013年3月期间，在一家拥有140张床位的社区医院开展了一项关于自动化群组监测和反馈系统的研究。
使用一个监测消毒剂和肥皂使用情况但不识别个体医护人员的电子系统，计算八个住院科室每个患者每小时的手部卫生事件以及六个门诊科室每个患者每次就诊的手部卫生事件。在为期六个月的基线期和三个月的推广期内监测手部卫生情况，但不提供反馈。在推广期间，开展焦点小组讨论以确定对反馈频率和形式的偏好。在为期六个月的干预期内，每月通过电子邮件向所有管理人员和行政人员发送图形报告，并再次开展焦点小组讨论。
反馈开始后，住院科室的手部卫生平均增加了0.17次/患者每小时（四分位距 = 0.14，p = .008）。在门诊科室，手部卫生执行情况没有显著变化。遇到了各种挑战，包括获取准确的人口普查和人员配备数据、增强对该系统的信心、在报告中传播信息以及利用数据推动改进。
通过自动化系统提供反馈与短期内手部卫生执行情况的改善相关。
