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Hand hygiene rates higher within presence of other HCWs
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The rates of hand hygiene were higher when health care workers were in the proximity of their colleagues, according to researchers from the University of Iowa.
“Hand hygiene is a critical infection control measure,” the researchers wrote in Infection Control and Hospital Epidemiology. “Yet reported rates of adherence remain low. Our results demonstrate that the presence and proximity of other [health care workers] is associated with higher hand hygiene rates. Although the effect that we estimated was modest, the positive effect was consistent at different times of day, for different measures of social context and after controlling for possible confounding factors.”
The researchers measured hand hygiene behavior using a wireless sensor network to measure interactions between health care workers (HCWs), their location and hand hygiene activity in a medical ICU for 10 days. Stationary sensors were placed in 20 patient rooms and other places through the unit. HCWs wore badges that they received at the beginning of their shifts. HCWs were divided into three groups: doctors, nurses and critical care support. Badges were randomly assigned to workers within each group.
Hand hygiene adherence was measured by using the sensors to identify hand hygiene opportunities and alcohol-dispenser activations. There were 47,694 opportunities and 14,989 dispenser activations during the study period, for an observed adherence of 27.1% (95% CI, 26.7-27.5).
To measure the social context, the sensors evaluated the number of co-workers encountered per minute. When workers had no recent HCW contacts, the observed hand hygiene adherence was 20.1% (95% CI, 19.8-21.9). However, in the presence of other HCWs, the observed adherence was 27.9% (95% CI, 27.5-28.3). The absolute increase of 7% is statistically significant.
“Our results speak to the importance of the social environment in health care,” the researchers wrote. “In future studies, the ability to track HCWs across multiple shifts may help discover ‘super-influential’ agents. The study of positive outliers may help us discover novel approaches to improve hand hygiene adherence and may also have implications for other behaviors related to patient safety.”
Disclosure: The researchers report no relevant financial disclosures.
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