Putting the "E" in HygiEne

This content is sponsored by DebMed.

Hand hygiene compliance monitoring via electronic surveillance is proven to increase compliance, help reduce the incidence of patient infection and drive down care costs.

Infection control and prevention is a major challenge faced by hospitals, surgery centers and long-term care facilities. Patient infections lead to more complex care cases and longer hospital stays — a lose-lose situation for both patients and hospitals. Healthcare-acquired infections impact patient safety, economics and continuity of care, making it a top quality issue for healthcare decision-makers.

It is well known that proper hand hygiene is the primary way to prevent these infections, and studies have shown that increased compliance can reduce the frequency of HAIs. Unfortunately, current methods to achieve higher compliance have not proven successful. The average rate of compliance across U.S. hospitals has remained around 40 to 50 percent for nearly a decade.

There is a better way
DebMed® has developed the world's first electronic hand hygiene compliance monitoring system based on the World Health Organization's Five Moments for Hand Hygiene, providing accurate, real-time feedback to help hospital staff increase compliance and decrease the spread of preventable and deadly infections.

Saving lives by eliminating medical complications and errors is essential in providing the highest level of care. Consider how proactive decisions about infection control could translate to improved outcomes and reduced costs. Revolutionary hand hygiene electronic monitoring technologies, such as the DebMed GMS™ (Group Monitoring System), can help deliver on the institution's key mission of better care delivery, while improving communication around true hand hygiene compliance rates among the nursing staff, physicians and infection control practitioners. In today's era where significant funds are being spent on electronic health records, electronic monitoring of hand hygiene represents a mere fraction of the cost, and contributes to hospitals' ability to demonstrate improved patient outcomes, such as shorter lengths of stay and lower mortality rates, with significant cost savings in their operations.

A higher clinical standard
The DebMed GMS is based on the World Health Organization's Five Moments for Hand Hygiene, which advises healthcare workers to clean their hands in the clinical setting:

  • Before touching a patient,
  • Before clean/aseptic procedures,
  • After body fluid exposure/risk,
  • After touching a patient, and
  • After touching patient surroundings.

These moments align with the evidence base concerning the spread of HAIs, which are among the leading cause of preventable deaths and increased healthcare costs in the U.S. The WHO Five Moments for Hand Hygiene guidelines also correspond with the Centers for Disease Control and Prevention recommendations. Studies show that when staff only clean hands before and after patient care, a common standard in hospitals, it only accounts for half of all hand hygiene opportunities, potentially putting patients at risk.

Hospitals are well aware of the safety and financial advantages of hand hygiene compliance. Unfortunately, The Joint Commission on Accreditation of Healthcare reports that the average hand hygiene rate of healthcare workers in the U.S. is only 48 percent. Current methods of monitoring, typically in the form of direct observation, bring various drawbacks including:

  • The Hawthorne Effect: People behave differently while being watched; workers improve or modify their habits, which results in inaccurate and overinflated compliance data being reported.
  • Small sample sizes: Due to cost and manpower limitations, direct observation techniques only capture 1.2 to 3.5 percent of all hand hygiene opportunities according to a study done at University of Iowa.
  • Observer bias: The staff doing the observations may not be properly trained, and inter-rater reliability means that one observer may interpret activities differently than another observer.

To put it simply, manual, costly strategies for monitoring hand hygiene compliance executed by staff are unreliable. Not to mention that staff, including nurses, should be devoting their time to patient care and not manual tracking. The DebMed GMS is impartial and unbiased, and eliminates challenges associated with the human element. The system captures 100 percent of hand hygiene events with accuracy, reported in real-time. Using statistically-validated algorithms, the technology automatically calculates compliance rates, and additionally provides supporting educational tools to enable behavioral changes to help hospitals improve staff compliance.

The DebMed GMS, a 2013 recipient of the North American Frost & Sullivan Award for New Product Innovation, utilizes scientifically-published research that for the first time benchmarks the number of hand hygiene opportunities based on hospital type (teaching vs. non-teaching), hospital size, and unit type (medical-surgical, critical care or emergency department). The data is dynamically customized to each hospital unit by accounting for the ever-changing patient census as well as other proprietary, hospital-specific factors that feed into the algorithm. It then calculates the number of times health care workers should have cleaned their hands, including tracking compliance at the point-of-care with specialized, away-from-wall monitored dispensers that provide access to hand sanitizer.

Controlling costs
Annually in the U.S., it's estimated that 1.7 million healthcare-acquired infections are responsible for nearly 100,000 fatalities, with direct costs as high as $45 billion. Infection control impacts both direct and indirect costs from a clinical perspective.

According to the CDC, implementing a comprehensive HAI prevention strategy that includes compliance with hand hygiene guidelines can generate a 70 percent reduction in HAIs, and estimated cost savings of $25 billion to $31.5 billion.

Those are large numbers on a large scale. Day to day, hospital leaders are forced to make tough dollar-and-cents decisions in the operation of their facilities, for instance: Can we afford this new equipment for treatment? Do we have the budget for more clinical staff? Purchases or expenditures must demonstrate their value by return on investment standards.

Electronic monitoring of hand hygiene, in the form of a data-based compliance feedback tool, must add to the bottom line by generating savings. It does so by helping hospital staff to reduce occurrences of healthcare-acquired infections, thereby enabling shorter hospital stays. Considering also the time and money spent on manual hand hygiene monitoring, the electronic method — which requires no upfront capital investment — frees up various resources, including staff and patient beds.

Commitment to the right choice
The reality is that not everyone is comfortable with change. The other significant reality is that adding cutting-edge infection control technology increases patient safety and lowers costs. It also has a positive impact on staff, patients and their families. Therefore, electronic hand hygiene monitoring systems should be part of a broader initiative to improve patient safety and quality of care.

In today's competitive healthcare environment, patients are seeking healthcare facilities with leading technologies to provide positive outcomes, combined with the best experience with the hospital, the staff and their physicians. They, too, want the fastest path to good health, and to minimize the negative impact of time away from their day-to-day life spent in the hospital. By implementing a leading-edge technology that contributes to higher quality care and short-as-feasible stays, you are establishing safe practices, a solid reputation and a positive image as a healthcare facility committed to best practices for your patients' care. Differentiation from the competition brings the potential to increase volume.

An electronic compliance monitoring system can also have a significant impact on workplace mindset. When employees have the necessary tools to allow them to be more efficient, job satisfaction is observed both in performance results and improved morale. With the addition of an automated monitoring system, hospital leadership needs to create a strategy to enhance education regarding compliance and expectations. It is important to consider how current organizational policies, processes, and resources support or challenge hand hygiene compliance. Talk with employees about attitudes, beliefs and perceptions related to hand hygiene, along with their willingness to change behaviors. The use of the technology needs to be geared to educate, train, support and monitor staff hand hygiene compliance.

As we execute tasks in our daily routines at both work and home, we've become more and more reliant on technology to solve problems and, frankly, make life easier. Demands for more efficient care are higher than ever; infection prevention — and technology that will give vital data to help control it — is a top priority.


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