Cheryl A. Littau

Use patterns and frequency of hand hygiene in healthcare facilities: Analysis of electronic surveillance data

HighlightsThis study presents detailed hand hygiene rates at 5 hospitals over 6 months.High‐accuracy electronic monitoring recorded millions of hand hygiene events.Certain job functions had significantly higher rates of hand hygiene product use.Hand hygiene products protect patients, but exposure data for healthcare workers are needed.95th percentile uses/hour of alcohol‐based handrub and handwash were 9.1 and 2.1, respectively. Background Healthcare workers perform hand hygiene much more frequently than workers in other fields. As a result, healthcare workers have a higher exposure to topical antiseptic products. Methods Five tertiary care facilities were equipped with an electronic hand hygiene compliance monitoring system. Alcohol‐based handrub (ABHR) and handwash use was recorded on a worker‐specific basis for 6 months. Total hand hygiene product use and total hours worked were calculated for each worker to determine use frequency. Results A detailed, descriptive analysis of hand hygiene practices was performed. All facilities demonstrated high hand hygiene compliance rates (>85%). ABHR use was more frequent (9.1 uses/hour, 95th percentile) than handwashing (2.1 uses/hour, 95th percentile). This study identified a relationship between hand hygiene frequency and job function. Nursing and nonclinical support staff demonstrated higher usage rates than other healthcare workers. For these workers with high hand hygiene frequency, 95th percentile usage rates for ABHR use and handwashing were 9.6 and 2.2 uses/hour, respectively. Conclusions This extensive dataset, monitoring nearly 4000 healthcare workers and more than 6 million data points, provides a detailed description of current hand hygiene practices of hospital staff. ABHR was used more frequently than handwashing. Job function was found to affect hand hygiene frequency, with nonclinical staff and nursing staff demonstrating elevated rates of hand hygiene.