According to the World Health Organization, proper hand hygiene can prevent up to 50% of Healthcare-Associated Infections (HAIs). To improve hand hygiene, it is essential to monitor compliance. Many hospitals rely on direct observation to monitor compliance, but this method is often flawed due to the Hawthorne effect—a phenomenon where individuals alter their behavior because they know they are being observed.

While compliance rates may appear high during observation, they do not accurately reflect day-to-day practices. Some studies have shown that, without observers, hand hygiene compliance can plummet by as much as 200%. This discrepancy highlights the need for more reliable monitoring methods to ensure genuine and consistent adherence to hand hygiene protocols.

For this reason, the Leapfrog Group strongly encourages the use of electronic hand hygiene monitoring systems like SwipeSense. These systems enable healthcare facilities to comprehensively track nearly every patient interaction, something not feasible with traditional observation methods. Additionally, electronic monitoring eliminates the ethical dilemma of an observer witnessing patient harm without intervening, ensuring a more accurate and ethical approach to hand hygiene compliance.

Key Considerations for Selecting an Electronic Hand Hygiene System

Not all electronic hand hygiene systems are created equal. It's crucial to select the right system tailored to a facility's specific needs. This involves asking the right questions and understanding explicitly how it will integrate into the facility, especially since even minor inconveniences can deter staff from using it effectively. Here are six essential factors to consider when choosing an electronic hand hygiene system:

1. Does the system fit seamlessly into clinician workflow?

Healthcare staff is busy and the electronic hand hygiene system should not add to their burden. One of the most important factors to consider in choosing a system is whether it integrates seamlessly into the existing workloads of staff. 

Key considerations include whether the system requires an additional wearable device, how frequently this device needs to be charged, and if staff need to pause or perform any extra actions to get credit for hand hygiene compliance. These factors are crucial as they can impact whether the system is perceived as convenient or cumbersome, directly influencing whether staff will use it consistently and benefit from it.

2. Does the system adapt to changing clinical conditions?

Patient statuses are ever-changing, and a robust hand hygiene system must keep pace with these dynamics. An electronic hand hygiene system should be able to respond to various clinical changes, such as modifications in isolation precautions.

For example, patients on Clostridioides difficile (C-diff) precautions require a completely different handwashing process compared to standard patients since alcohol-based hand sanitizers are ineffective against C-diff spores. These patients require thorough handwashing with soap and water, and the hand hygiene system should be able to adjust its protocols accordingly.

It is crucial that the system can instantly recognize and adapt to these changes, ensuring compliance and maintaining high standards of infection control. Additionally, it should provide adequate time for healthcare workers to don and doff personal protective equipment (PPE), ensuring that safety is never compromised.

3. Does the system offer real-time feedback?

Real-time feedback is the immediate notification provided to staff about missed hand hygiene opportunities. This feedback is critical because it allows staff to correct their actions on the spot, thereby reinforcing proper hand hygiene practices. The goal is not only to measure compliance but also to actively improve it by ensuring that staff are aware of and can address any lapses as they occur.

Recognizing the importance of this, the Leapfrog Group has identified real-time feedback as a crucial component of effective hand hygiene programs. Their survey even includes a requirement for direct observations to be conducted alongside electronic monitoring. Observers must immediately intervene before any harm occurs, providing non-compliant individuals with immediate feedback to ensure swift corrective action.

The system should provide alerts in a way that is both effective and unobtrusive, whether through visual cues or audio signals. The alerts must also be accurate and trustworthy, since unreliable alerts can contribute to alarm fatigue and reduce overall compliance. Ensuring that staff receive timely, clear, and reliable real-time reminders helps maintain high standards of hygiene and ultimately reduce HAIs.

4. Does the system support behavioral change?

The true effectiveness of electronic hand hygiene systems is in their ability to drive behavioral changes among healthcare staff. A robust system should be able to demonstrate its impact on reducing HAIs and improving hand hygiene compliance. SwipeSense, for example, has been shown to decrease HAIs by up to 49% after one year.

Another way to find effective partners is to look at who has been approved by safety organizations like Leapfrog. "Innovators for Leapfrog” have been recognized for their innovations in patient safety, infection prevention, and healthcare quality, signifying that their system has demonstrated a positive impact on health outcomes.

5. Does the system collect individual data?

Collecting individual data is crucial for tailoring educational efforts and interventions to improve hand hygiene compliance. By monitoring individual performance, healthcare facilities can identify specific areas where staff members need additional training or support. This personalized approach not only enhances overall compliance but also engages staff by allowing them to see their own scores and progress.

6. Is the system secure?

In today's healthcare landscape, security is paramount, especially with the increasing threat of data breaches and cyber-attacks. When selecting an electronic hand hygiene system, it's essential to ensure it is secure and does not compromise patient privacy. Look for a system that operates as a closed network, which means it does not collect or store personal health information (PHI) or any private patient data. By avoiding the handling of sensitive information, these systems minimize the risk of data leaks and enhance overall security.

SwipeSense: Meeting All Your Hand Hygiene System Needs

SwipeSense stands out by seamlessly integrating into clinical workflows without burdening staff. Its lightweight badge reel requires no charging or additional actions for credit, making hand hygiene monitoring effortless. SwipeSense also integrates with electronic medical records (EMR) to promptly update hand hygiene reminders based on clinical parameters, all without collecting PHI, so as not to be a security risk. 

Other key features of SwipeSense’s Electronic Hand Hygiene Monitoring include:

• Provides real-time feedback with personalized voice reminders: SwipeSense uses customizable Natural Language Voice Reminders when hand hygiene is missed. Hospitals can tailor these reminders using the voices of trusted staff in various languages, which has been shown to enhance compliance by reducing response times compared to traditional alarms.
• Data-driven improvements: SwipeSense leverages data to drive significant improvements in hand hygiene compliance and infection rates. For example, a teaching community hospital saw a 192% increase in facility-wide hand hygiene compliance over 12 months using SwipeSense.
• Utilizes individual data for targeted improvements: SwipeSense collects and analyzes individual hand hygiene data, enabling targeted education and personalized feedback.

Achieving Effective Hand Hygiene Compliance

As recommended by the Leapfrog Group, implementing an electronic hand hygiene monitoring system can significantly increase hand hygiene compliance and help hospitals improve their Leapfrog ratings. It’s essential to ask the right questions and ensure the chosen system seamlessly integrates into the facility’s workflows, adapts to changing clinical conditions, and supports behavioral changes. By selecting the best system, healthcare providers can consistently use and benefit from it, ultimately leading to improved patient safety and reduced HAIs.