Eight Reasons to Install an Electronic Hand Hygiene Compliance Solution


By Amanda Holdan-Sinisi

hand washing reduces hais

Why consider installing an electronic hand hygiene compliance solution in your hospital? For care providers, hand hygiene compliance is basic. Of course, you know to wash your hands. It’s one of the first things you learned in school, most likely preschool. The problem lies within the fact that infection preventionists and nurse managers can’t be there to remind or coach healthcare workers to clean their hands at every hand hygiene opportunity, but electronic hand hygiene compliance solutions can. They also validate facilities’ safety obligation to ensure that hand hygiene is properly performed with each patient engagement.

In many cases, electronic hand hygiene compliance solutions have gentle reminders to perform hand hygiene if healthcare workers overlook it, or simply forget. Having the reminder has proven to be very powerful – reminders increase  hand hygiene compliance over 40%.

Hand hygiene increases compliance by 44% with gentle reminders

We use reminders all the time in our personal lives- for appointments, birthdays, to take vitamins and to call people. Why not use reminders to clean our hands in the hospital, especially in busy environments?

If you are a hospital officer or an infection preventionist, consider these eight reasons an electronic hand hygiene compliance solution installation can help your hospital exceed its performance goals.

1. Build a Solid Foundation for Patient Safety and Infection Prevention
Hospitals spend millions of dollars each year on infection prevention efforts.  These efforts include disposable personal protective equipment, disinfecting solutions and wipes, UV disinfection systems, and catheters and central lines with antimicrobial technology to name a few. But without addressing hand hygiene, the fundamental cornerstone of infection prevention, hospitals are starting on a faulty foundation. In other words, it’s like building a house without a basement or cement slab- depending on where you live.

Without first addressing hand hygiene compliance, all other efforts will be less effective.  HAIs will continue to spread, costing the facility more harm and money, and its reputation. If you are an advocate for your team and your patients, and you want a solid house, it’s time to consider an electronic hand hygiene compliance solution.

2. For Your Patient’s Safety
The Patient Safety Movement and Handwashing for Life are well-known, proactive Patient Safety organizations. The Patient Safety Movement is driven by the mission to get to zero preventable deaths. As part of this mission, The Patient Safety Movement is asking hospitals to implement their Actionable Patient Safety Solutions (APSS) which recommends an Electronic Hand Hygiene Compliance Solution in “Challenge 2: Healthcare-associated Infections.”

The Handwashing for Life Institute’s charter is devoted to advancing the science of hand hygiene with the purpose of reducing the incidence of foodborne illness caused by poor hand hygiene practices. Interestingly, the organization believes in power of the data recorded by electronic hand hygiene compliance solutions and is now advocating for these solutions in multiple industries.

The Leapfrog Group supports their mission of “safety, quality and affordability of U.S. health care” by delivering Hospital Safety Grades to help patients understand which hospitals provide the “safest care.” Hand washing is rated under “Practices to Prevent Errors” since it is the cornerstone of infection prevention and patient safety.

Last year, The Joint Commission took another step toward improving hand hygiene under IC, NPSG standards. With these recent requirements, how can hospitals ensure that all care providers are meeting hand hygiene requirements without an active reminder  solution?

Whether directly or indirectly, any organization advocating for patient safety recommends or is in support of the use of electronic hand hygiene compliance solutions.

3. Increase Patient Satisfaction and Engagement
Increasing patient satisfaction is paramount for many hospital executives. What better way to let patients know that your hospital staff have clean hands than proving it? By simply installing an electronic hand hygiene compliance solution solution, hospitals have experienced an increase in patient satisfaction.

A visitor to a hospital with an electronic hand hygiene compliance solution shared his story:

“Last weekend I was visiting a family member at Downstate Hospital when I asked a nurse about the badge she wore. She replied,” it’s a hand wash detector.” I was very impressed and had a huge sense of comfort not to worry about germs and diseases being transmitted because of bad (hand) hygiene. My family member was in the right place.”

– Edward Mayers, family member

4. Substantial Financial Savings
Electronic hand hygiene compliance solutions directly improve the overall clinical, operational and financial performance of the organizations that use them. Let’s look at some numbers.
The following is a snapshot of the negative impact of three infection types over the course of a year for a 400+ bed hospital. And these numbers don’t even include the cost of potential penalties.

# Cases Excess                                  Cost per case*           Excess cost for total cases          Increase in Length of Stay (days) per case*      Increase in LOS for total cases
36 cases of CLABSI                                     $48,108                                 $1,731,888                                                           13.2                                                                                       475.2
12 cases of CAUTI                                        $13,793                                 $    165,516                                                             2.6                                                                                         31.2
78 cases of C. diff                                         $17,260                                 $1,346,280                                                             5.7                                                                                       444.6

*Excess Cost per Case $’s reflected are Https://ahrq.gov/professionals/quality-patient-safety/pfp/haccost2017

An electronic hand hygiene compliance solution can reduce HAIs up to 80% after the first year of implementation. To conservatively show the significant cost savings and reduction in patient days, we’ll only use 25%.

25% Fewer Cases                           Costs Savings                        LOS Reduction
27 case of CLABSI                                    $432,972                                     118.8   days
9 cases of CAUTI                                      $   41,379                                               8   days
58 cases of C.diff                                       $345,200                                        114   days

To summarize, this hospital reduced their patient days by 241 and saved $819,551 by avoiding 32 HAI cases.  All because an electronic hand hygiene compliance solution reduced their HAIs by 25%.

5. Accurate Data You Can Use
Besides saving time and money, electronic hand hygiene compliance solutions exponentially increase the amount and accuracy of hand hygiene compliance data recorded. In general,by using direct observation methods, a hospital may observe and record 200 hand hygiene events every month, or 2,400 a year. And let’s be honest- we know that the accuracy of direct observation is questionable. Hospitals that use conventional methods to assess hand hygiene rates (direct observation/ secret shopper) commonly report a compliance of 90-95% rate, knowing that the number is inflated by the act of observation (Hawthorne effect). In fact, it’s most likely closer to 40%.

With the right electronic hand hygiene compliance solution, hand hygiene events captured range between 16,000 – 20,000 a day (depending on the number of beds) or 5.8M events a year. Most importantly, the compliance rate collected with these events is accurate, not compromised by bias, observation, or human error. By collecting the right data and running the right reports, you should be able to see where individuals and teams need to improve (not for punitive measures- we love our care providers), who is exceeding their goals, and longer term, how system use correlates with increased compliance, reduced HAIs and reduced staff absenteeism.

6. Massive Time Savings
Managing direct observation and secret shoppers is time consuming for nurse managers and infection preventionists. It’s not effective because of the Hawthorne Effect (people act differently when they know they are being observed) and not enough data is collected to make it viable. Additionally, the time required for collecting data and making meaningful calculations is cumbersome. electronic hand hygiene compliance solutions remove this burden by doing everything automatically; collecting data and building easy to read reports which allow care providers to focus on patient care instead of crunching compliance numbers.

7. Dramatically Reduce HAIs
The clinical evidence in support of electronic hand hygiene solutions is increasing – Electronic hand hygiene monitoring solutions with reminder systems are in fact reducing HAIs. Results vary depending on the facility and length of time the system has been in place. White Plains Hospital published a recent study in the American Journal of Infection Control citing a 45% reduction in CLABSI and 55% reduction in CAUTI. Other hospitals are seeing similar results but have not yet published. One example includes San Gorgonio Hospital in California. San Gorgonio experienced a 50% reduction in C. diff after one year. In 2018, the team reported zero C. diff cases.

8. Increase and Sustain Hand Hygiene Compliance
Awareness campaigns and conventional hand hygiene initiatives can improve compliance, but only temporarily. Once the campaign is over, compliance rates tend to fall back to their baseline levels. Sustained hand hygiene compliance can only be accomplished with a gentle reminder. Not all electronic hand hygiene compliance solutions are the same- some only track hand hygiene. It’s important that you select a solution with a reminder to support care providers in following safety protocols and enable hospitals to increase and sustain compliance. If you are starting from 40%, increasing to 95% and sustaining it makes a world of difference to the safety culture overall. Many hospitals using electronic hand hygiene compliance solutions are experiencing sustained compliance above 95%.

Every healthcare provider thinks they clean their hands according to hospital protocol, but it’s always helpful to have a 24 x 7 reminder, for those times when someone forgets. Think about it this way: if it was you or your loved one lying in the hospital bed, wouldn’t you much prefer to know that the care provider has clean hands instead of having to ask? And with all these benefits (8 reasons), how can it not be a priority?

Facilities already performing at extremely high levels can choose to demonstrate their brilliance with hand hygiene by implementing a system that has a reminder, reiterating to staff and patients that they are receiving exceptional care.