Hospital reports hand hygiene compliance rates nearly double national average

Amid the early days of the COVID-19 pandemic, select units at the University of Chicago Medical Center achieved daily hand hygiene compliance rates of more than 90%, and some even hit 100% at one point, data show.

Though hand hygiene “is a cornerstone of infection control,” compliance averages only 50% nationwide, Sonya Makhni, MD, MBA, a clinical informatics fellow, hospitalist and Master of Science in Biomedical Informatics candidate at the University of Chicago, and colleagues wrote in JAMA Internal Medicine. “Audit and feedback can improve compliance, but audits traditionally occur using direct observation, capturing few events and leading to inaccurate measurements.”

The University of Chicago Medical Center tracks hands hygiene via Purell’s Smartlink Integrated Monitoring System (Gojo Industries), which the researchers said utilizes an infrared sensor to anonymously track use of its dispensers as one steps into or out of an inpatient unit. The researchers analyzed daily, weekly and monthly data from the dispensers from September 2019 through August 2020 for 13 inpatient units, four of which were converted into COVID-19 cohort units, and six ICUs, including three that were used for patients with COVID-19. During the study period, 1,159 inpatients with COVID-19 were admitted to the hospital.

The researchers reported that across all units prior to the COVID-19 pandemic, monthly hand hygiene compliance hovered around 55%. Compliance reached a daily peak of 92.8% across all units on March 29, 2020, and 100% in the COVID-19 cohort units on March 28, 2020. The weekly compliance peak of 88.4% across all units and 98.4% in the COVID-19 cohort units was achieved the week of March 29, 2020, and the monthly peak of 75.5% across all units and 84.4% in the COVID-19 cohort units in April. The compliance rate across all units was at its lowest in August, at 51.5% on August 15, 2020, 55.1% that same week and 56% that same month.

The researchers did not assess the quality of the hand hygiene.

“As hospitals set hand hygiene goals, this study suggests high compliance is possible, even with automated monitoring, yet difficult to sustain,” Makhni and colleagues wrote.

“The recent decline in compliance should be a clarion call to hospitals currently experiencing COVID-19 surges.”