Mobile App Significantly Boosts Hand Hygiene Observation Collection, Streamlines Process

A free mobile application drastically improved and streamlined hand hygiene observation collection at a pediatric hospital in south Texas, boosting both the number of audits completed and eliminating certain staff roles in the process, according to a poster presented at the Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference, held June 13-15, 2022, in Indianapolis, Indiana.

“The impetus behind this [poster] was, there is growing interest in new technology around this sort of data collection, largely these electronic hand hygiene monitoring systems that use RFID technology to track health care worker movements around the facility,” Danielle J. Durant, PhD, MBA, MS, assistant professor of health sciences at Texas A&M University and poster presenter, told Infection Control Today® in a video interview. “There’s this social consciousness around, ‘we should be getting these systems in our facilities.’ [In] the hospital I was working with on this project, the infection prevention and control department kind of got the same directive from executive leadership” to explore some new methods to modernize the data collection process.

Durant and colleagues led the interventional, pre-post study at a 191-bed pediatric hospital in south Texas, which compared a free mobile application called iScrub with traditional pen and paper methods of hand hygiene observation collection. Previously, staff were conducting on-the-floor observations, as per the Joint Commission gold standard, and recording the data manually. Using the app instead of pen and paper streamlined the collection process.

“[The app] works like any other kind of app on your phone…You open it up and you can start a data collection session. On the screen, there are options to collect the normal data you would collect during an observation What kind of health care worker am I observing? Is it a doctor? Is it a nurse? You can indicate whether or not they used a wash or a rub, [did they] wash at a hand hygiene station or use a sanitizer rub? Did they wear the appropriate [personal protective equipment]?” Durant explained. “The mobile app just replaces the pen and paper booklets. We were kind of shocked at how that little process change allowed this entire process to become a lot more efficient.”

Trained observers relied on the app for hand hygiene observation collections between June 18 and November 30, 2021, and logged a 140% increase in observations collected, from 3082 pre- to 7388 post-app. Other benefits included the ability to record additional information and comments for each observation, less time spent collecting each observation, and automated transmission of observation data to the infection preventionist, which eliminated observers having to remember to “hand in” observation booklets to the administrative staff for manual processing.

Durant and colleagues hypothesize that, over time, use of the mobile app could also reduce operational costs, since it eliminates the need for the physical booklets, an administrative staff member to input data, and a decision support analyst for additional analysis.

Staff members at the study site found the app easy to use and convenient.

"As a quality champion, I'm not going down to the department to pick up little booklets; I'm also not having to drop them off. It just makes the whole process easier," Durant said.