Infectious disease physician Andrew G. Sahud, MD, of the Division of Infectious Diseases at Allegheny General Hospital in Pittsburgh, Pa., has invented a pedometer-like device he hopes will help boost hand hygiene compliance and raise awareness among healthcare workers.
Sahud, who also serves as chairman of the infection prevention department, says he was frustrated with the observational methodology for determining hand hygiene, something he says is time-consuming but more importantly, “never gives the healthcare provider individualized feedback,” Sahud emphasizes. “I was driving my car into the garage which uses an radio frequency technology to open the gate with the car badge and thought that this sort of technology could be used to monitor hand hygiene and serve as a kind of pedometer to give feedback,” he explains. “I did some investigation on radio frequency technology and its applications. The hospital helped me to obtain patent protection and some grant money helped me to develop prototypes. I worked with an engineer to develop and test prototypes which I included in my study that we completed last fall.”
In his study, Sahud and colleagues (2010) sought to evaluate the feasibility of using an electronic hand hygiene surveillance and feedback monitoring device in a 700 bed tertiary care teaching hospital. The two-phase pilot study included initial direct observation of hand hygiene practices as part of routine hospital quality assurance (phase I) and subsequent monitoring using an electronic hand hygiene surveillance device (phase II). During phase I, healthcare workers were directly observed at patient room entry and exit from April 2008 to November 2008. During phase II, hand hygiene data were gathered through indirect observation using the electronic device in August 2009. Twenty patient rooms were fitted with electronic trigger devices that signaled a reader unit worn by participants when they entered the room, and 70 dispensers for liquid soap or hand sanitizer were fitted with triggers that signaled the reader unit when the dispenser was used. The accuracy of the devices was checked by the principal investigator, who manually recorded his room entries and exits and dispenser use while wearing a reader unit.
During phase I, hand hygiene occurred before room entry for 95 (25.1 percent) and after room exit for 149 (39.4 percent) of 378 directly observed patient room visits, for a cumulative compliance rate of 32.3 percent. Among the 378 room visits, 347 (91.8 percent) involved contact with the patient and/or environment. During phase II, electronic monitoring revealed a cumulative composite compliance rate of 25.5 percent. The electronic device captured 61 (98 percent) of 62 manually recorded room entries and 133 (95 percent) of 140 manually recorded dispensing events.
