Using electronic monitoring to ensure workers are compliant with the WHO's Five Moments of hand hygiene might be a great way to lower the threat of superbugs at hospitals.

MRSA and other hospital acquired infections (HAIs) can be reduced by up to 42 percent, according to researchers from the Greenville Health System (GHS) in South Carolina who had utilized data from DebMed Electronic Hand Hygiene Compliance System that is Five Moments compliant.

The system is a hand-cleaning dispenser that also monitors hospital workers’ “Five Moments,” in which the WHO recommends that health care workers should wash their hands before touching a patient, before clean/aseptic procedures, after body fluid exposure/risk, after touching a patient and after touching the patient’s surroundings.
The image below highlights the WHO's Five Moments.



In the study, researchers analyzed the data collected by the system in order to measure the impact of hand hygiene compliance rates and how often HAIs occur. They found that compliance rates increased by 25.5 percent when workers used the system.

The researchers also found that hospital onset MRSA HAI rates decreased by 42 percent and the total cost of care that was avoided by using the system was approximately $434,000.

"The 23 [inpatient] units included six intensive care, 15 medical/surgical, and two rehabilitation units," Connie Steed, MSN, RN, CIC, director of infection prevention at GHS and co-author of the study, told HCB News. "The 33-month study timeframe was divided into three equal 11-month time periods to assess differences of patient or unit characteristics over time.

“We moved away from Direct Observation (DO), which captures only a small fraction of hand hygiene behavior and omits events that occur in the patient room,” she said.

She also said that studies have shown that health care workers behave differently when they are observed, with one recent study showing a three-time increase in hand hygiene compliance when they knew they were being observed as opposed to being unobserved.

Over 20 million hand hygiene events from the DebMed system were submitted to Greenville Memorial Hospital. According to the announcement, from April 2014 to March 2015, hospital members were “fully engaged with the use of the data” and unit leaders in the hospital had to ensure that there was an increase in hand hygiene compliance.

“Integrating a validated technology capable of tracking WHO Five Moments Behavior in our processes provided us with actionable feedback to drive staff behavior change that resulted in hand hygiene compliance and decreased infection rates,” said Dr. J. William Kelly, principal investigator and infectious disease specialist at GHS.

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