Pilot Study Demonstrates Effectiveness of New Method for Monitoring Hand Hygiene Compliance

Epidemiologists and computer scientists at the University of Iowa have collaborated to create a new low-cost, green technology for automatically tracking the use of hand hygiene dispensers before healthcare workers enter and after they exit patient rooms.  This novel method of monitoring hand hygiene compliance, which is essential for infection control in hospitals, was released today at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).

“We know that a range of pathogens are spread from healthcare workers to patients by direct touch and that the current rates of hand hygiene compliance are suboptimal,” said Philip Polgreen, MD, University of Iowa Health Care.  “Our new low-cost method of monitoring could potentially reduce cost while increasing compliance rates.”  The failure of healthcare workers to perform appropriate hand hygiene is one of the leading preventable causes of healthcare-associated infections.

This new technology marks a major shift from the current method of monitoring hand hygiene compliance that involves direct human observation, which is both costly and labor intensive.  With human observation there is also the potential for a “Hawthorne Effect,” which means workers will only clean their hands when being actively observed.  Older automated monitoring technology, called radio-frequency identification (RFID) infrastructure, is available, but can be prohibitively costly and consumes far more power than Polgreen’s method.

The pilot study uses “Zigbee” technology which is part of a new generation of wireless devices that require less power. Workers wear small, pager-sized badges to monitor their use of hand hygiene dispenser stations prior to entering patient rooms.  The technology behind the study was developed in collaboration with computer scientists at Iowa.  Ted Herman, the lead computer scientist on the project, designed badge construction and placement of small beacons inside patient rooms and other designated locations.  “A novel part of our method is how data are recorded,” Herman said, “data are recorded and processed in the badges rather than relying on a network.”  Each use of the dispenser station is automatically reported by the user’s badge, which logs the time and length of use, date and dispenser ID number. The data from the badges can be automatically off-loaded multiple times, which means results are recorded and aggregated without any manual data entry.