Oct. 30, 2014
In the history of medicine, almost nothing has made a bigger impact on improving patient health and improving hospital safety than the simple act of washing hands.
As someone who spends a great deal of my time going in and out of the hospital, and in and out of patient rooms – we all think we do a really good job with hand hygiene, but in reality, I don’t think we are quite as effective as we think.
In recent years, there has been an explosion of alcohol hand dispensers around the hospital, but things happen – physicians and nurses get paged or called into another patient’s room, there is yet another urgent matter that needs our immediate attention. In this environment it doesn’t take much to potentially put patients, staff, and families at risk.
So how can we actually know how well we are doing with hand hygiene compliance?
Often times facilities will ask staff members to watch other employees, but that is neither sustainable nor generally effective. Most individuals, if they know they are being watched, will ultimately change their behavior, which is known as Hawthorne effect. This makes it difficult to know if these changes will continue once the observation period has ended and develop into positive behavioral patterns.
There is also another approach – giving patients a manual survey where they can check a box to indicate if medical staff interacting with them actually sanitized or washed their hands. Again, it can be useful for certain pieces of information, but there is most likely significant accuracy issues. Many patients – particularly older patients with cognitive problems, patients with significant pain, or patients who have family members talking to them in the room – may not see that a nurse or a doctor washed their hands and might document that incorrectly. Of course with different retrospective biases, opposite problems can occur as well.
Therefore, the question is: ‘What’s possible today when it comes to monitoring hand hygiene compliance?’
With the solutions powered by real-time location systems (RTLS) and other sensing technologies, healthcare organizations can now have a business intelligence dashboard that provides a real-time visualization of who is compliant, the percentage of time they were in compliance, and where the compliance varies.
With such a level of data granularity, there is potential of resistance. Some individuals might feel that this is going to turn into yet another way for hospital administration to penalize nurses and other staff, to bear down further on their physicians, and come up with reasons to make their life harder.
However, the reality is that by using automated hand hygiene monitoring technology, administrators will know where they truly stand and step back and look at the processes in an intelligent and accurate way. The data can, for example, bring our attention to a particular hospital room with a low compliance rate. It might turn out that a reason behind it is simply because the alcohol dispenser or sink was placed inconveniently – causing difficulty for healthcare workers to follow the hand hygiene protocols.
Ultimately, technology can lead to very simple solutions to improve the ability for healthcare workers to take care of patients safely and create the best healing environment possible.