North Shore University Hospital on Long Island in the US has taken a new approach to hand hygiene, which has produced dramatic results.
The hospital worked with Arrowsight, a US developer of a patented third-party remote video auditing platform (RVA) to monitor hand hygiene and conduct a pilot to increase hand hygiene among healthcare professionals in their medical intensive care unit (MICU).
Over an initial 16-week period, hospital employees were monitored to establish a base rate of hand hygiene compliance without any feedback to them. Using a very strict definition of hand hygiene (requiring healthcare workers to perform hand hygiene before and after patient care within 10 seconds of entering and exiting the room, regardless if gloves were used), their rates were in line with previously documented findings at around 10%.
During the next 16-week period, staff received real-time feedback on their performance via LED screens mounted on the walls of the MICU and from management. Within weeks of providing feedback, the hand hygiene rate during the second period rose to in excess of 80%.
During a subsequent 17-month maintenance period, a sustained rate of well above 80% was achieved. More than 430,000 hand hygiene data points were collected during the 25-month study period.
Details of the study have been published in the journal Clinical Infectious Diseases.
“Hand washing has been shown to be the backbone of infection control for the last 150 years. It is one of the most important aspects of preventing the spread of infectious diseases from patient to patient by the hands of healthcare professionals. This is the first time we've used third-party remote video auditing technology, combined with continuous real-time feedback. The results were not only very significant but also showed a sustained improvement in hand hygiene compliance in our facility over a two-year period,” said Bruce Farber, chief of infectious diseases at North Shore University Hospital who oversaw the study.
“Our staff reacted very positively to the programme. They did not feel their privacy was being violated or unfairly observed. It has engendered a sense of teamwork in keeping compliance rates high. Quality patient care is critical and North Shore remains committed to the study of, and prevention of, hospital-acquired infections and other infectious diseases.”
Adam Aronson, chief executive of Arrowsight added: “Dr Farber and the staff at North Shore University Hospital were willing to give RVA the opportunity to help improve patient care. Their dedication enabled us to prove that the platform works in this industry as it has in others and is a big step forward in the battle against HAIs.”