Digital Wristband Provides a Fuller Picture of Hand Hygiene Compliance in an Intensive Care Unit

In order to address barriers to hand hygiene (HH) compliance among health care workers (HCWs), we must first understand the behavior on an individual level, particularly in the intensive care unit (ICU) setting.

A team of investigators at the University of Louisville set out to gather data on HH compliance and patient contact time among ICU HCWs using an electronic sensor-based HH measurement system called Sanibit by Microsensor Labs. The wearable wristband works with location sensors throughout the hospital to track HH and HCW behavior, and then pairs with an app that analyzes individual performance. The data were presented in a poster at the Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference, held June 13-15, 2022, in Indianapolis, Indiana.

“The takeaway from this study is really there is significant individual variation by day of the week, by hour of the day,” Jiapeng Huang, MD, PhD, professor and vice chairman of the Department of Anesthesiology & Perioperative Medicine at the University of Louisville, co-founder of Microsensor Labs, and study presenter, told Infection Control Today® in a video interview.

Data were collected from 15 HCWs (12 nurses, 2 patient care assistants, and 1 secretary) at a 10-bed surgical ICU and analyzed to track HH compliance by day of the week, hour of the day, dispenser location, and patient care duration. A total of 27,692 interactions were recorded over a 6-month period.

Notably, investigators found that HH was performed more regularly upon exit from the patient room compared with entrance (37.3% vs 26.1%; P < .001). HH compliance rates varied widely among individuals but stayed relatively stable when comparing day of the week and hour of the day, except for weekends when compliance dipped.

Overall, investigators note that their findings reinforce the need for continuous education and reminders that are specific to HCWs, time, and location.

“Technology is just a tool,” Huang said. “If you just buy the technology, your HH will not improve. You have to have the entire package…The more we study HH, the more complex we realize it is.”