Health systems are constantly working to decrease their rates of hospital-acquired infections. Beyond the obvious patient safety concerns, their bottom lines could depend on it, with new Medicaid payments systems that some states are adopting. The new requirements make it more critical than ever to reduce HAIs with specific targets for these infections.
Denver Health Medical Center has gotten on top of the problem by implementing automated location monitoring technology to help boost hand hygiene adherence, a variable the Joint Commission recognizes is the most important way to prevent hospital-acquired infection transmissions.
Since implementation of the technology two years ago, baseline hand hygiene adherence rates at Denver Health jumped from about 40 percent to a sustained rate of more than 70 percent, according to hospital officials.
"Denver Health had been interested in electronic hand hygiene monitoring for some time," said Heather Young, MD, medical director of infection prevention at Denver Health Medical Center. "We piloted a product that estimated hand hygiene rates on a unit level, but we had poor uptake with frontline staff because they felt as though the estimates were inaccurate."
When the institution invested in a new nurse call system, it decided to pilot an electronic hand hygiene monitoring system from CenTrak to track individual hand hygiene rates and provide objective feedback to fellow staff members.
While hand hygiene is a critical goal of nearly all healthcare in hospitals and clinics, the market for electronic hand hygiene monitoring systems is not overly large. Some vendors of the technology include AiRISTA Flow, BioVigil, EcoLab, Stanley Healthcare and Vitalacy.
At Denver Health Medical Center, the CenTrak monitoring system is used on two of the medical-surgical wards, the medical intensive care unit, and the step-down care unit. On these particular units, all rooms are single occupancy.
All nurses and healthcare technicians on these floors, as well as those on the float team, have badges. Additionally, select hospitalists, intensivists and residents also have badges to track their personal electronic hand hygiene adherence.
"We monitor both waterless hand sanitizer and soap dispensers," Young explained. "We have defined adherence with the technology to be performing hand hygiene within 60 seconds before or after entering the room and within 60 seconds before or after leaving the room."
Denver Health has used the electronic hand hygiene monitoring system as a means to both effect and measure change in hand hygiene. For example, it has used electronic hand hygiene to study the effect of poster placement on hand hygiene habits. It also has provided individual feedback to staff members on their hand hygiene rates and studied the change in electronic hand hygiene over time.
The hospital has achieved quite a success with baseline hand hygiene adherence rates nearly doubling. While Denver Health measures multiple hand hygiene workflows, this particular example of improved compliance was in regard to its wash-in/wash-out protocol – the requirement for staff to wash their hands upon entering a room and again after their interaction with a patient.
"Using data from the electronic hand hygiene compliance system, Denver Health was able to properly audit hand hygiene processes and provide additional training and education to staff where needed most," said Young.
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