Objective: To determine the utility of an electronic monitoring system in ascertaining and enhancing HH adherence among HCWs entering the proximity of patient care areas in a pediatric oncology unit
Methods: The monitoring system includes a bed monitor which establishes a seven foot safe radius infrared/acoustic field around a patient bed, an electronic badge for HCWs, and a hand wash station (HWS) that can monitor HH. Data from monitors, badges, and HWS are transmitted to a database. HH was performed with soap containing 4% isopropyl alcohol or a 62% ethanol gel. The system was installed in a 30-bed pediatric oncology unit at a stand-alone, pediatric facility in South Florida.
Results: During September 3rd – October 10, 2010 (study period), 79 HCWs participated, representing 6315 HWS interactions, 6888 monitor interactions, and 9,759 true badge log-in events. There was 100% correlation between badge and monitors and 100% correlation between the badge and HWS. The mean daily compliance to HH among physicians (436 hand washing events) and nurses (7,834 hand washing events), was similar at 94%, respectively. All data were accurately transmitted to the database; the system detected all attempts to approach a monitor or bed without conducting HH and appropriately warned the respective HCW to perform HH.
Conclusions: The electronic system performed with 100% accuracy during a five-week study period, provided monitoring at the same intensity for all shifts in a busy pediatric oncology unit, and maintained HH compliance among physicians and nurses consistently above 90%. Communications between the badge, monitor, HWS, and database were exceptionally reliable. HCWs entering the proximity of a patient bed without performing HH were reminded to do so 100% of the time. These results suggest that electronic monitoring of HH among HCWs has an important role to play in current and future endeavors to reduce HAI in US healthcare facilities.