In the past, inhouse spies have monitored compliance. In the near future, radio-frequency monitoring will be used.
Because at a hospital, an employee with dirty hands can have severe consequences for a patient. So the University of New Mexico Hospital is going to spend upward of a million dollars over the next several years on technology that will serve as a hand-hygiene watchdog of sorts to ensure physicians and other staff have cleaned their hands before touching patients. It will also allow hospital officials to track which doctors, nurses and other staff skimp on the sanitizer.
“Our goal is patient safety,” said Dr. Meghan Brett, an infectious disease physician at UNMH and the hospital epidemiologist. “If we can do a better job of tracking hand hygiene then I think we can do a better job of keeping our patients safe.”
Last week, UNM regents signed off on UNMH purchasing an Ecolab system to track hand hygiene for physicians and staff. The tracking system will use employee badges to monitor when the employees use sinks or hand-sanitizer dispensers before contacting a patient.
According to Ecolab’s website, the system will track when a doctor or nurse enters a patient’s room and whether or not they clean their hands. The employee badge will then either turn red or green and could also give an audible alert once the health care provider approaches the patient’s bed, indicating if the hands have been cleaned or not. After the visit, the system will track if the physician cleaned their hands before leaving the room.
Data on the cleanliness of each doctor, nurse or other employee will be trackable for hospital administration.
“I like to think of it as Jiminy Cricket on your shoulder, reminding you to do what’s good,” Brett said.
The hospital currently uses undercover employees to monitor handwashing practices.
Claudia Tchiloyan, manager of Infection Prevention and Control at UNMH, said certain employees, after getting additional training, occasionally monitor handwashing habits of their peers and report their findings to hospital officials. The observers’ identities are originally kept secret.
“Some of them are not known and some of them eventually are,” Tchiloyan said of the hand-washing spies. “Because of the nature of human beings – there is talk. So most of the time people do know who is there to do observations.”
UNMH follows standards set by the World Health Organization on hand hygiene, which essentially calls on doctors to clean their hands before and after seeing each patient, and sometimes during exams.
How often do doctors follow those guidelines? The hospital’s surveillance program has found UNMH physicians and nurses to be pretty clean. Tchiloyan said the observational reports indicate that UNMH staff use proper hygiene about 90% of the time.
The Centers for Disease Control, however, report grimmer statistics. The CDC says that health care workers clean their hands less than half of the times they should, and that one out of 31 hospital patients has at least one health care-associated infection, according to the CDC’s website.
Either way, Brett said it can’t hurt for the hospital’s hygiene to improve. And it’s not like hands can be too clean.
She said the exact cost of the project isn’t known, as Ecolab is currently going through the hospital’s infrastructure, which will determine cost. The contract is for three years, and it can be extended after that. UNM documents show that a three-year deal would put the program’s cost at under $1 million and four years may make the program cost more than $1 million. The new monitoring system is expected to be up and running within months.
“There have been studies that have shown even an additional 5% of boosting your hand hygiene rates reduces infection transmissions,” Brett said. “There is no upper limit. If we can improve in any way to make patients safer, that’s a good thing.”