Effects of reminders from Sanibit™ electronic hand hygiene system and incentives on hand hygiene compliance: a prospective, four-phased, observational study.

BACKGROUND

Individualized reminders and incentives from automated hand hygiene monitoring systems (AHHMSs) might contribute to significant hand hygiene improvement.

AIM

To comprehensively evaluate the implementation of the Sanibit™ AHHMS system in the intensive care unit and the impact of these interventions on hand hygiene compliance in a four-phased, prospective trial at a tertiary care hospital.

METHODS

The Sanibit monitoring system was installed in a 10-bed neurological intensive care unit. Phase 1: no reminder, cash incentive. Phase 2a: lights only, cash incentive. Phase 2b: lights + vibrations, cash incentive. Phase 3: no reminder, point system incentive. Phase 4: lights + vibrations, point system incentive.

FINDINGS

The accuracy rate detected by the Sanibit, compared with direct observations, was 85.1%. Phase 2a with lights only and cash incentives achieved the most hand hygiene opportunities in the middle of the week. Phase 4 with lights and vibrations reminders and point system incentives achieved the best in terms of total, full, and partial hand hygiene compliance, while phase 2a with lights only and cash incentives had the highest hand hygiene opportunities. Hand hygiene compliance rates of going-out room events were significantly lower than those of going-in room events for quick in-and-out room, while the opposite held true for long in-and-out room events.

CONCLUSIONS

Hand hygiene opportunities, compliance, and patient contact times varied significantly among different reminders/incentives, individual healthcare workers, day of the week and time of the day. Lights and vibration reminders and point system incentives achieved the best hand hygiene compliance.