Journal
INTERNATIONAL JOURNAL OF MEDICAL INFORMATICS
Volume 80, Issue 8, Pages 596-603Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijmedinf.2011.04.002
Keywords
Monitoring; Hand hygiene; Embedded system; Information system
Categories
Funding
- Health Technology Exchange (HTX)
- Canadian Institutes of Health Research [HTX 80047, XHT 83447]
- Registered Nurses Foundation of Ontario
- Andrew J Hart Enterprises Limited
- Toronto Rehabilitation Institute and the Ontario Centers of Excellence [TO-CR-1007 4-08]
- Ministry of Health and Long-Term Care in Ontario
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Background: Inadequate hand hygiene (HH) by healthcare staff results in increased rates of hospital acquired infections in healthcare institutions, considerable waste of resources, and negative economic impact for the healthcare system. Toronto Rehabilitation Institute has developed an automated HH monitoring system that detects HH opportunities, generates HH reminding signals when it is necessary and enables hospital management to monitor individual and aggregated HH performance on ongoing basis. Objective: To demonstrate that HH improvement is feasible with the proposed technical solution and that technology is acceptable by potential users. Methods: The technology was installed in four rooms on a nursing unit of a larger complex continuous care hospital. The rooms were selected to make it possible to automatically follow the same nurses for the duration of their entire shift. Eleven nurses were provided with the wearable electronic HH monitors as well as with the instrumented personal wearable alcohol gel dispensers. Stationary gel dispensers installed in the unit were also instrumented with technology. Results: Over 145 h of testing the system automatically recorded a total of 1438 events of entering and leaving monitored rooms and indicated an average of 6.42 HH actions per hour. The baseline observational study indicated 4.2 HH actions per hour. Approximately half of the HH actions recorded by the system were performed using personal wearable alcohol gel dispensers. Conclusion: The results obtained when testing the embedded HH monitoring system demonstrated the feasibility of HH improvement and proved that proposed solution merits a larger and longer clinical trial to measure the degree of improvement and the sustainability of that improvement. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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