Relaunch of an electronic monitoring system to sustain hand hygiene observations and compliance: A quality improvement study.

Abstract

Background: Hand hygiene (HH) can help prevent infections in health care settings. Our hospital implemented an electronic HH monitoring system (EHHMS) in fall 2021 to increase HH compliance. Initial improvements decreased below established goals over time. This quality improvement study aimed to determine the effectiveness of an EHHMS relaunch to achieve sustainable improvement in HH observations and compliance.

Methods: HH observations were tracked based on staff entries and exits from patient rooms; HH compliance was the ratio of HH events over HH observations. The relaunch in February 2023 focused on standardization of expectations, leadership engagement, development of reference materials, and sharing weekly data.

Results: During initial EHHMS implementation, the mean HH observations were 80.3 per patient-day, with HH compliance of 94.8%; HH observations then decreased to 63.0 per patient-day with 93.7% compliance. The relaunch resulted in significant sustained improvement, with 79.0 mean HH observations per patient-day (28.2% increase) and 94.6% HH compliance (P < .001). These gains were sustained throughout the following 18-month control period.

Discussion: Implementing an EHHMS improved HH compliance. Success depended on frontline leaders' buy-in, practical interventions, and continuous feedback. Future studies should explore long-term sustainability and broader effects.

Conclusions: Sustained performance after EHHMS implementation requires a comprehensive plan.