Hand Hygiene
Measurement Technology
Presenter:
Jane Kirk MSN RN CIC
Clinical Director Healthcare
GOJO Industries, Inc.
January 2015
LEARNING OBJECTIVES
At the end of this presentation you will be able to:
• Describe 3 barriers to hand hygiene compliance
• Name 3 technologies to consider for measuring
HH
• Discuss and identify the differences between
AMS and RTLS
4
Hand Hygiene & Healthcare Associated Infections
Why is This Important?
1. 1.7M HAI’s are reported each year
2. 99,000 deaths each year, attributable to HAI’s
3. 1 out of every 20 hospitalized patients will contract an HAI
4. Length of Stay (LOS) increases up to 18 days
5. HAI’s cost the U.S. health care system billions of dollars each year
6. CDC cites proper hand hygiene as #1 intervention in fighting HAIs
7. Compliance rates in the US average less than 50%
8. Global research indicates that improvements in hand hygiene
activities could potentially reduce HAI rates by up to 50%
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Why is hand hygiene compliance so low?
Average Compliance is less than 50%, nationally
• Too busy—high workloads—hands full—multiple distractions
• HCWs forget—already thinking about next task
• Inconvenient placement of sinks and dispensers
• Skin irritation and dryness due to handwashing
• Not a habit—safety culture doesn’t stress importance of hand
hygiene at all levels of organization
• Inadequate knowledge of hand hygiene guidelines and protocols
*2009 Joint Commission Center for Transforming Healthcare
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Economics of HAI’s
1.
In almost all cases, hospitals did not receive full reimbursement; on average,
hospitals statewide were paid approximately 27% of the established charges.
2.
The hospital must absorb the additional costs associated with HAI’s, while the
HAI’s simultaneously prevent new admissions w/ reimbursable conditions.
Economics of HAI’s
Business Case / ROI Focus:
• Excess cost of HAI’s – Hospital dependent
• Excessive length of stay (LOS) – lost opportunity cost
• Define multi-modal strategy and needed resources
Hand Hygiene Improvement = Higher Standard of Care
How is hand hygiene monitored today?
1. Direct observation
2. Consumption modeling
3. Patient Surveys
C O N F I D E N T I AL
Compliance Management Approaches
Video
Surveillance
Cost
Person Specific
Monitoring
Observation
App’s
Area/Group
Monitoring
Direct (manual)
Observation
Impact
Three Primary Technologies to Consider …
1. Area / Group Monitoring
2. Individual / Role Monitoring
3. Direct Observations Apps
Option #1 – Activity/Group Monitoring
 Entry/Exit activity
 Dispenser activity
 Compliance by location
o Building, floor, unit, room
 Automated Reporting – 24/7
 Not “Big Brother”
o “Community” metric / no badges
o Team based performance
 Group-level reporting structure
 Little IT infrastructure required
Option #2 – RTLS / Individual Monitoring
Asset
Management
Equipment
Maintenance
Condition
Monitoring
Patient &
Staff Safety
Patient
Flow
Productivity,
quality performance,
safety
ER wait times,
OR / bed scheduling
Hand Hygiene
Fewer purchases,
reduced rentals, loss
prevention
PMs, locating,
change in status
Improve Patient Care •
Spoilage Reduce
HAIs,
pharmaceuticals,
Improve
blood,outcomes
organs
Reduce Costs
•
Increase Safety
•
ROI
Option #2 – RTLS / Individual Monitoring
Dispensers
Badges
Sensory Network
RTLS Software
ECM – Dashboard & Reporting
Customized reporting
• Provides data by:
•
Location (floor, unit, room)
– Formulation (soap vs. sanitizer)
– Date range
– Shift
– Device
– Role
– Person
–
•
Data available 24/7
Direct Observation System / APP
•
•
•
•
Pen / Paper
Excel / PowerPoint
Time Consuming
Prone to Errors
•
•
•
•
•
App for iPad / iPhone & Android
Auto-feed into Software
Increases standardization of data
Significant increased efficiencies
Statistically relevant data
Additional Technology …
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Video monitoring
Motion sensors that detect patient room entry and exit
Wearable devices that dispense sanitizer & track HCW’s
Wrist worn devices that track HH events and techniques
Patient tracking devices
Virtual wall technology
SMART Dispensers
Measurement Alone is not Enough …
A Few Methods to Improve Hand Hygiene
Compliance:
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•
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•
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Staff & Patient Education
Observation & Feedback
Convenient Dispenser Placement
Reminders
Sanctions & Rewards
Leadership Engagement / Priority
Avoid Understaffing / Excessive Workload
1. Hand Hygiene = #1 intervention in fighting HAIs
2. You can’t manage what you can’t measure
Q&A