Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA.
Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA; King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Am J Infect Control. 2019 Sep;47(9):1102-1106. doi: 10.1016/j.ajic.2019.03.011. Epub 2019 Apr 17.
No single strategy is more effective than proper hand hygiene (HH) in reducing the spread of nosocomial infections. Unfortunately, health care worker compliance with HH is imperfect. We sought to improve HH compliance using an electronic hand hygiene monitoring system (EHHMS) in 2 units to collect unbiased data and provide feedback.
In this prospective, quasi-experimental study, the Hyginex EHHMS was installed in 2 units at Tufts Medical Center. Ninety-one bracelets were assigned, and electronic data were collected over 8 months. Human observations continued. We compared HH compliance as measured by human observation before, during, and after EHHMS implementation. Pre- and post-implementation surveys were distributed to staff.
The number of electronically captured HH compliance observations was small due to infrequent bracelet use after month 2 of the intervention. HH compliance, as determined by human observation, increased by an average of 1.3 percentage points per month (P = .0005). Survey responses revealed negative attitudes about the EHHMS before and after its implementation.
Despite poor EHHMS participation and negative attitudes toward its implementation, HH compliance, as measured by human observation, significantly improved. Hospitals considering implementing an EHHMS should look to refine the intervention to encourage health care worker participation.
没有哪种单一策略比正确的手部卫生（HH）更能有效减少医院感染的传播。不幸的是，医护人员执行 HH 的情况并不完美。我们试图通过在 2 个单位使用电子手部卫生监测系统（EHHMS）来提高 HH 依从性，以收集无偏见的数据并提供反馈。
在这项前瞻性、准实验研究中，在塔夫茨医疗中心的 2 个单位安装了 Hyginex EHHMS。分配了 91 个手镯，并在 8 个月内收集电子数据。仍继续进行人工观察。我们比较了 EHHMS 实施前后和实施期间通过人工观察测量的 HH 依从性。在实施前后向员工分发了调查问卷。
由于干预后第 2 个月手镯使用频率较低，电子捕获的 HH 依从性观察次数较少。通过人工观察确定的 HH 依从性平均每月增加 1.3 个百分点（P=0.0005）。调查答复表明，在实施前后，员工对 EHHMS 的态度都是负面的。
尽管 EHHMS 的参与率低，对其实施的态度消极，但通过人工观察测量的 HH 依从性显著提高。考虑实施 EHHMS 的医院应寻求改进干预措施，以鼓励医护人员参与。
