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Article: Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology
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TitleIntroduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology
 
AuthorsCheng, VCC1
Tai, JWM1
Ho, SKY1
Chan, JFW1
Hung, KN1
Ho, PL1
Yuen, KY1
 
Issue Date2011
 
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/
 
CitationBmc Infectious Diseases, 2011, v. 11 [How to Cite?]
DOI: http://dx.doi.org/10.1186/1471-2334-11-151
 
AbstractBackground: MedSense is an electronic hand hygiene compliance monitoring system that provides Infection Control Practitioners with continuous access to hand hygiene compliance information by monitoring Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" guidelines. Unlike previous electronic monitoring systems, MedSense operates in open cubicles with multiple beds and does not disrupt existing workflows.Methods: This study was conducted in a 6-bed neurosurgical intensive care unit with technical development and evaluation phases. Healthcare workers (HCWs) wore an electronic device in the style of an identity badge to detect hand hygiene opportunities and compliance. We compared the compliance determined by the system and an infection control nurse. At the same time, the system assessed compliance by time of day, day of week, work shift, professional category of HCWs, and individual subject, while the workload of HCWs was monitored by measuring the amount of time they spent in patient zones.Results: During the three-month evaluation phase, the system identified 13,694 hand hygiene opportunities from 17 nurses, 3 physiotherapists, and 1 healthcare assistant, resulting in an overall compliance of 35.1% for the unit. The per-indication compliance for Moment 1, 4, and simultaneous 1 and 4 were 21.3% (95%CI: 19.0, 23.6), 39.6% (95%CI: 37.3, 41.9), and 49.2% (95%CI: 46.6, 51.8), respectively, and were all statistically significantly different (p < 0.001). In the four 20-minute sessions when hand hygiene was monitored concurrently by the system and infection control nurse, the compliance were 88.9% and 95.6% respectively (p = 0.34), and the activity indices were 11.1 and 12.9 opportunities per hour, respectively. The hours from 12:00 to 14:00 had a notably lower compliance (21.3%, 95%CI: 17.2, 25.3) than nearly three quarters of the other periods of the day (p < 0.001). Nurses who used shared badges had significantly (p < 0.01) lower compliance (23.7%, 95%CI: 17.8, 29.6) than both the registered nurses (36.1%, 95%CI: 34.2, 37.9) and nursing officers (34.0%, 95%CI: 31.1, 36.9) who used named badges.Conclusion: MedSense provides an unobtrusive and objective measurement of hand hygiene compliance. The information is important for staff training by the infection control team and allocation of manpower by hospital administration. © 2011 Cheng et al; licensee BioMed Central Ltd.
 
ISSN1471-2334
2012 Impact Factor: 3.025
2012 SCImago Journal Rankings: 1.278
 
DOIhttp://dx.doi.org/10.1186/1471-2334-11-151
 
PubMed Central IDPMC3129590
 
ISI Accession Number IDWOS:000292374400001
Funding AgencyGrant Number
University Grant Council of Hong Kong
Food and Health Bureau of Hong Kong Government
Funding Information:

This study was supported in part by the Research Scheme of the University Grant Council of Hong Kong and the Research Fund for the Control of Infectious Diseases Commissioned Study of Food and Health Bureau of Hong Kong Government.

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheng, VCC
 
dc.contributor.authorTai, JWM
 
dc.contributor.authorHo, SKY
 
dc.contributor.authorChan, JFW
 
dc.contributor.authorHung, KN
 
dc.contributor.authorHo, PL
 
dc.contributor.authorYuen, KY
 
dc.date.accessioned2012-08-08T08:51:50Z
 
dc.date.available2012-08-08T08:51:50Z
 
dc.date.issued2011
 
dc.description.abstractBackground: MedSense is an electronic hand hygiene compliance monitoring system that provides Infection Control Practitioners with continuous access to hand hygiene compliance information by monitoring Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" guidelines. Unlike previous electronic monitoring systems, MedSense operates in open cubicles with multiple beds and does not disrupt existing workflows.Methods: This study was conducted in a 6-bed neurosurgical intensive care unit with technical development and evaluation phases. Healthcare workers (HCWs) wore an electronic device in the style of an identity badge to detect hand hygiene opportunities and compliance. We compared the compliance determined by the system and an infection control nurse. At the same time, the system assessed compliance by time of day, day of week, work shift, professional category of HCWs, and individual subject, while the workload of HCWs was monitored by measuring the amount of time they spent in patient zones.Results: During the three-month evaluation phase, the system identified 13,694 hand hygiene opportunities from 17 nurses, 3 physiotherapists, and 1 healthcare assistant, resulting in an overall compliance of 35.1% for the unit. The per-indication compliance for Moment 1, 4, and simultaneous 1 and 4 were 21.3% (95%CI: 19.0, 23.6), 39.6% (95%CI: 37.3, 41.9), and 49.2% (95%CI: 46.6, 51.8), respectively, and were all statistically significantly different (p < 0.001). In the four 20-minute sessions when hand hygiene was monitored concurrently by the system and infection control nurse, the compliance were 88.9% and 95.6% respectively (p = 0.34), and the activity indices were 11.1 and 12.9 opportunities per hour, respectively. The hours from 12:00 to 14:00 had a notably lower compliance (21.3%, 95%CI: 17.2, 25.3) than nearly three quarters of the other periods of the day (p < 0.001). Nurses who used shared badges had significantly (p < 0.01) lower compliance (23.7%, 95%CI: 17.8, 29.6) than both the registered nurses (36.1%, 95%CI: 34.2, 37.9) and nursing officers (34.0%, 95%CI: 31.1, 36.9) who used named badges.Conclusion: MedSense provides an unobtrusive and objective measurement of hand hygiene compliance. The information is important for staff training by the infection control team and allocation of manpower by hospital administration. © 2011 Cheng et al; licensee BioMed Central Ltd.
 
dc.description.naturepublished_or_final_version
 
dc.identifier.citationBmc Infectious Diseases, 2011, v. 11 [How to Cite?]
DOI: http://dx.doi.org/10.1186/1471-2334-11-151
 
dc.identifier.citeulike9381740
 
dc.identifier.doihttp://dx.doi.org/10.1186/1471-2334-11-151
 
dc.identifier.hkuros209841
 
dc.identifier.isiWOS:000292374400001
Funding AgencyGrant Number
University Grant Council of Hong Kong
Food and Health Bureau of Hong Kong Government
Funding Information:

This study was supported in part by the Research Scheme of the University Grant Council of Hong Kong and the Research Fund for the Control of Infectious Diseases Commissioned Study of Food and Health Bureau of Hong Kong Government.

 
dc.identifier.issn1471-2334
2012 Impact Factor: 3.025
2012 SCImago Journal Rankings: 1.278
 
dc.identifier.pmcidPMC3129590
 
dc.identifier.pmid21612666
 
dc.identifier.scopuseid_2-s2.0-79957473581
 
dc.identifier.urihttp://hdl.handle.net/10722/157635
 
dc.identifier.volume11
 
dc.languageeng
 
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcinfectdis/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofBMC Infectious Diseases
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshElectronics - instrumentation - methods - organization and administration
 
dc.subject.meshGuideline Adherence - organization and administration
 
dc.subject.meshHandwashing - standards
 
dc.subject.meshHygiene - standards
 
dc.subject.meshInfection Control - instrumentation - methods - organization and administration - standards
 
dc.titleIntroduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO "My 5 Moments for Hand Hygiene" methodology
 
dc.typeArticle
 
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Author Affiliations
  1. Queen Mary Hospital Hong Kong