Infection Control through Hand Hygiene: Two Success Stories from Daily Practice - Hand disinfection in OR

Infection Control through Hand Hygiene: Two Success Stories from Daily Practice

Thorough hand disinfection is crucial to patient health in all areas of a hospital – from neonatal care to intensive care. However, in the stressful everyday hospital environment, it can often be overlooked. Modern technology can provide valuable support.

Mobile counter as a motivator

Small device, big effect: The Asklepios hospital in Hamburg, Germany has introduced the HyHelp System to increase the number of hand disinfections. In addition to training staff and measuring the amount of disinfectant used, as routinely carried out in the hospital, doctors and nurses now wear a small mobile device attached to their clothing. This device automatically detects when the hand disinfectant has been used and gives immediate positive feedback to the healthcare worker in the form of a green light. At the touch of a button, an integrated counter shows the total number of times the hand disinfectant is taken, so that at end of the day each team member knows how often they have disinfected their hands. The device also reminds staff to disinfect their hands. Each ward can select its own criteria. For example, alerts can be set before and after contact with patients. The mobile device can also be set to emit a signal when a staff member leaves the patient environment so then the green LED, which is lit when at the patient's bedside or in a sterile workplace, goes out. Additionally, the number of individual disinfections per hour can be measured. The staff can be reminded to disinfect their hands by means of a warning light or a vibration alert.

"A key factor in gaining acceptance among staff members is the fact that the technology does not permit central monitoring of the individuals," says Dr. Susanne Wenner-Ziegler, hospital hygienist and medical specialist in microbiology and infection epidemiology. Each individual knows his or her own disinfection rate and also the average rate for the ward, but no one else, not even their supervisor, can view individual values. "We are convinced that a sustainable increase can only be achieved through a high degree of self-motivation on the part of nurses and doctors. A controlled approach would be counterproductive here," says Wenner-Ziegler.

Anonymous statistics for the ward

In addition to providing this individual motivation, the device also collects useful data, which is then collated anonymously for each ward. The team can view the results on a monitor. Hospital hygienist Wenner-Ziegler sees this transparent feedback as valuable information. For example, if the number of hand disinfections per week goes up by ten per cent, this represents a success for the team. On the other hand, any fall in the numbers can be analysed so that procedures can be improved.

"This technology has enabled us to achieve a considerable increase in the already high number of hand disinfections," says Wenner-Ziegler. But she also points out the limitations of the system: "Of course, technology cannot do it alone. Improving compliance in matters of hand hygiene is hard work for all concerned."

Data collection at the dispenser

Another way of collecting data is by means of automatic measurement at the hand sanitizer dispenser. The NRW Heart and Diabetes Centre (HDZ NRW) is the first clinic in Germany to introduce this technology in all wards. The center specializes in all forms of heart disease and diabetes across all age groups. Many of the clinic's patients are older and have multiple morbidities and, like premature babies, are susceptible to immune system disorders. This means that there is a particularly high risk of infection in the presence of germ colonies. Following a pilot phase lasting several months, HDZ NRW has replaced more than 1,000 dispensers with these new devices. Each time a dispenser is used, an anonymous signal is transmitted to a server. This enables the actual consumption and the frequency of use throughout all in-patient areas to be monitored via WLAN over a wide area.

For years, this university hospital has already been monitoring the amount of disinfectant used per day. Now the new system provides more specific data so the actual amount used in each ward can be determined.

Improved training

"If consumption is lower than our specifications dictate, we can react immediately," says consultant Dr. Claudia Christine Freytag, who is in charge of hospital hygiene. "We can also tell if a dispenser is not being used enough because it is not yet positioned at the best place within the ward. It also means that hand hygiene training, which is already being carried out in each ward several times a year and includes practical exercises, can be matched even more closely to actual needs."

The cost of the whole project runs into six figures.

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