Technology Plan
The recommendations of specific technologies or products herein are those of the Patient Safety Movement Foundation and do not necessarily represent the opinions of the Joint Commission Center for Transforming Healthcare or its affiliates. The Joint Commission Center for Transforming Healthcare was not consulted on, nor did it participate in the decision or choice of any specific product or technology, and as a matter of policy the Joint Commission Center for Transforming Healthcare does not endorse any specific technologies, equipment, or other products.
There is emerging evidence that electronic hand hygiene compliance systems, when combined with appropriate staff feedback and multi modal action plans can lead to reduced infections and avoided costs. Visit
http://www.ehcohealth.org/the-evidence/ for a list of scientific studies.
Essential Criteria to Consider
The system must be:
- Capable of capturing 100% of all hand hygiene events (soap and sanitizer) electronically in real-time.
- Capable of reporting Hand Hygiene Compliance (HHC) based on the WHO 5 Moments for Hand Hygiene at the Group, Unit, Ward or Department Level.\cite{Steed_2011}
- Validated for accuracy in at least one peer reviewed study.\cite{Diller_2014}
- Supported by scientific evidence of efficacy.
- Supported with a behavior and culture change tool kit.
Consider an Electronic Monitoring System for Hand Hygiene Compliance to ensure an accurate and reliable data set from which real improvement can be driven, such as:
- Biovigil Hand Hygiene Compliance & Surveillance System
- DebMed: DebMed GMS (Group Monitoring System)
- GOJO Industries: GOJO SMARTLINK Hand Hygiene Solutions
- HandGieneCorp: HandGiene HHMS (Hand Hygiene Monitoring System
- Hyginex
- Hill Rom
- Hygreen
- IntelligentM: IntelligentM Smartband System
- Proventix: nGage
- Stanley Healthcare: Hygiene compliance monitoring system
- UltraClenz: Patient Safeguard System (PSS)
- Versus: SafeHaven with Versus RTLS and Versus Advantages Hand Hygiene Safety (HHS) software
Metrics
Topic
Observed Hand Hygiene Compliance
Compliance rate of hand hygiene by observation
Outcome Measure Formula
Based on the “My five moments for hand hygiene” method.\cite{Sax_2007,Sax_2009} Moments defined as:
- Before patient contact,
- Before aseptic task,
- After body fluid exposure,
- After patient contact and
- After contacts with patient surroundings.
The formula can be used to calculate hand hygiene compliance during all 5 moments. Moments 1 and 4, before and after patient contact are key calculations.
Numerator: Number of hand hygiene actions performed
Denominator: Number of hand hygiene actions required (hand hygiene opportunities)
*Rate is typically displayed as Events/10,000 Adjusted Patient Days
Metric Recommendations
Direct Impact: All Patients
Lives Spared Harm:
\(Lives\ =\ \left(Compliance\ Rate_{measurement}\ -\ Compliance\ Rate_{baseline}\right)\ x\ Healthcare-associated\ Infection\ Rate\ _{baseline}\)
Data Collection: Direct observation of hand hygiene practices in identified clinical settings with one (or two) trained and validated observers. Observers will watch healthcare workers’ hand hygiene practices at the point-of-care. The observer openly conducts observations but the identities of the healthcare workers are confidential. Based on WHO Guidelines on Hand Hygiene in Healthcare (2009) and “Save lives, Clean Your Hands” campaign.(World Health Organization 2009)