Hospitals have fretted for years over how to make sure doctors, nurses and staff keep their hands clean, but with only limited success. Now, some are turning to technology – beepers, buzzers, lights and tracking systems that remind workers to sanitize, and chart those who don’t.
Health experts say poor hand cleanliness is a factor in hospital-borne infections that kill tens of thousands of Americans each year. The U.S. Centers for Disease Control and Prevention in Atlanta estimates that one of every 20 patients in U.S. hospitals gets a hospital-acquired infection each year.
“We’ve known for over 150 years that good hand hygiene prevents patients from getting infections,” said Dr. John Jernigan, an epidemiologist for the CDC. “However, it’s been a very chronic and difficult problem to get adherence levels up as high as we’d like them to be.”
Hospitals have tried varying ways to promote better hygiene. Signs are posted in restrooms. Some even employ monitors who keep tabs and single out offenders.
Still, experts believe hospital workers wash up, at best, about 50 percent of the time. One St. Louis-area hospital believes it can approach 100 percent adherence.
Since last year, SSM St. Mary’s Health Center in the St. Louis suburb of Richmond Heights, Mo., has been the test site for a system developed by Biovigil Inc., of Ann Arbor, Mich. A flashing light on a badge turns green when hands are clean, red if they’re not. It also tracks each hand-cleaning opportunity – the successes and the failures.
The failures have been few at the two units of St. Mary’s where the system is being tested, the hospital said. One unit had 97 percent hand hygiene success, said Dr. Morey Gardner, the hospital’s director of infection disease and prevention. The other had 99 percent success.
“The holy grail of infection prevention is in our grasp,” Gardner said.
The Biovigil system is among many being tried at hospitals. A method developed by Arrowsight, based in Mt. Kisco, N.Y., uses video monitoring. It is being used in intensive care units at North Shore University Hospital in Manhasset, N.Y., and the University of California San Francisco Medical Center.
Akron, Ohio-based GOJO Industries, maker of Purell hand sanitizer, has developed an electronic compliance monitoring system using wireless technology to track when soap and hand sanitizer dispensers are used. The SmartLink system gives the hospital data on high- and low-compliance areas. The company said it has installed the system at several hospitals around the country, but didn’t say how many.
HyGreen Inc.’s Hand Hygiene Reminder System was developed by two University of Florida doctors. The Gainesville, Fla., company now features two systems used in seven hospitals, including Veterans Administration hospitals in Chicago, Wilmington, Del., and Wilkes-Barre, Pa.
One is similar to Biovigil’s green badge method. In HyGreen’s, a wall-mounted hand wash sensor detects alcohol on the hands. The badge includes an active reminding system. Unclean hands create a warning buzz. If the buzz sounds three times, the worker is noted for noncompliance.
HyGreen spokeswoman Elena Fraser said hospital infections have dropped 66 percent at units of Miami Children’s Hospital where the badge system has been implemented.
The CDC’s Jernigan said the high-tech systems can only help.
“For a health care worker, keeping their hands clean is the single most important thing they can do to protect their patients,” Jernigan said.