Author:
Koff Matthew D.,Brown Jeremiah R.,Marshall Emily J.,O’Malley A. James,Jensen Jens T.,Heard Stephen O.,Longtine Karen,O’Neill Melissa,Longtine Jaclyn,Houston Donna,Robison Cindy,Moulton Eric,Patel Hetal M.,Loftus Randy W.
Abstract
BACKGROUNDHealthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development.OBJECTIVETo explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events.DESIGNRandomized, prospective study.SETTINGDartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts.PATIENTSPatients undergoing surgery.METHODSOperating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections.RESULTSA total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82–1.40], P=.626).CONCLUSIONSThe hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy.Infect Control Hosp Epidemiol 2016;37:888–895
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Microbiology (medical),Epidemiology
Cited by
41 articles.
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