A first-of-its-kind study has shown a direct correlation between using data from the DebMed Electronic Hand Hygiene monitoring system and improvements in compliance with the World Health Organization (WHO) Five Moments standard - significantly reducing hospital-acquired MRSA infections.
MRSA is a form of bacterial infection that can be transferred on hands, is resistant to antibiotics, and is difficult and expensive to treat. In the UK alone, in 2015, there were 301 trust-assigned cases of MRSA, costing an estimated £7.5m to the NHS.
The study, which was published in the American Journal of Infection Control is entitled Electronic Hand Hygiene Monitoring as a Tool for Reducing Healthcare-Associated Methicillin-resistant Staphylococcus aureus Infection, and was conducted at Greenville Health System (GHS) in Greenville in the US state of South Carolina.
Researchers utilised hand hygiene compliance data from the DebMed system to measure the impact of hand hygiene compliance rates on the incidence of healthcare-associated infections (HCAIs), such as MRSA. In addition, the study showed that costs associated with providing care to infected patients over an extended length of stay were avoided.
Key findings included:
- Hand hygiene compliance rates increased by 25.5%
- Hospital-onset MRSA HCAI rates decreased by 42%
- The total costs of care avoided were approximately $434,000
J William Kelly, MD, infectious disease specialist at Greenville Health System Hospital, and principal investigator of the study, said: “This breakthrough research proves that real-time electronic monitoring of hand hygiene compliance based on the WHO Five Moments standard can lead to clinically-important organisational change and improved patient safety.
“Integrating a validated technology capable of tracking WHO Five Moments behaviour in our processes provided us with actionable feedback to drive staff behaviour change that resulted in increased hand hygiene compliance and decreased infection rates.”
The study was conducted between July 2012 and March 2015 in 23 inpatient units. Data on hand hygiene compliance rates, representing over 20 million hand hygiene events, from the DebMed electronic monitoring reports were provided to unit leadership and frontline staff at Greenville Memorial Hospital, GHS’s flagship tertiary hospital.
From April 2014 through March 2015, hospital staff were fully engaged with the use of the data and unit leaders were held accountable for increasing hand hygiene compliance. The study was supported by Deb Worldwide Healthcare, which had no influence on the design, conduct, analysis, or results of the study.
Connie Steed, director of infection prevention at GHS, and a MRSA study co-author, has been working with DebMed for the past seven years. The collaboration demonstrated that electronic monitoring technology based on the WHO Five Moments can accurately and reliably measure hand hygiene compliance and now, with this new study, that the DebMed System enables feedback that can drive behaviour change leading to reduced MRSA infections and associated costs.
“Over a seven-year research collaboration we achieved significant milestones and now have credible outcomes to show that MRSA HCAIs can be reduced when staff are trained on WHO Five Moments and given accurate and reliable feedback based on data from electronic monitoring,” said Steed.
“We moved away from Direct Observation (DO), which captures only a small fraction of hand hygiene behaviour and omits events that occur in the patient room.
Studies show that healthcare workers behave differently when being observed, with one recent national study showing a three-fold increase in hand-hygiene compliance when healthcare workers were observed as compared to when unobserved.
“Our study clearly demonstrates that technology like DebMed’s can lead to significant improvement in hand hygiene rates, a reduction of infections and improved patient outcomes.”
UK politicians hailed the findings as an important step forward for better hand hygiene compliance in UK hospitals.
“I am excited by Deb Group’s recent findings,” said Andrea Jenkyns, MP for Morley and Outwood and founder of the Handz campaign, which aims to raise awareness around hand hygiene in hospitals.
“After losing my own father to the hospital infection, MRSA, in 2011 I am personally aware of the tragic consequences such infections can cause.
“If electronic hand hygiene monitoring systems can reduce the rate of healthcare-acquired MRSA infections by as much as 42% this will surely help save lives and prevent tragedies like what happened to my father and my family. I would like to see every hospital taking this issue more seriously and it is exciting to see the possibility of this technology making its way into our hospitals.”
In England, approximately 300,000 patients develop a healthcare associated infection every year, with 5,000 of those cases proving fatal. HCAIs are estimated to cost the NHS up to £1billion each year.
The DebMed System is based on the WHO Five Moments for Hand Hygiene