Evaluation of an Electronic Device for Real-Time Measurement of Alcohol-Based Hand Rub Use

BACKGROUND. Observational surveys of hand hygiene compliance are time consuming. Measuring the use of a hand hygiene product is a less time-consuming method of monitoring the frequency of hand hygiene performance. OBJECTIVE. To evaluate the usefulness of electronic devices for monitoring alcohol-based hand rub use. DESIGN. Prospective observational trial. SETTING. A university-affiliated teaching hospital. METHODS. Prototypes of an electronic device designed to record each time a dispenser is used (hereafter referred to as a hand hygiene event) were placed in alcohol-based hand rub dispensers on the general medical ward and in the surgical intensive care unit. Data were downloaded wirelessly to a data logger and then uploaded to a dedicated Web site for analysis. Alcohol-based hand rub dispensers were located in patient rooms and in corridors. RESULTS. During a 6-month trial, 105,462 hand hygiene events occurred in the surgical intensive care unit, and 44,845 events occurred on the general medical ward. The dispensers located in patient rooms accounted for 47% of the hand hygiene events performed in the surgical intensive care unit but for only 36% of events on the general medical ward (P < .001). The dispensers most often used were located in corridors. Hand hygiene events were most common on Tuesdays, Wednesdays, and Thursdays, between 7:00 AM and 11:00 AM. CONCLUSIONS. The use of these electronic devices provided an efficient and accurate method of monitoring the frequency of alcohol-based hand rub performance on the general medical ward and in the surgical intensive care unit, and yielded more detailed information on usage patterns than did expressing use as liters per 1,000 patient-days. The wireless downloading of data from dispensers required a limited amount of time, and the dedicated Web site facilitated data analysis. Such devices should prove useful in monitoring the impact of various interventions on the frequency of hand hygiene performance.