410 Paper
410 Paper
410 Paper
Handwashing/hand sanitizing is the way to prevent hospital-acquired infections (HAI) and from
patients from acquiring these infections. Protecting not only patients but also ourselves as nurses
is important in keeping us in the best health possible so we can give our patients the best care
possible. Hand hygiene can sometimes be overlooked because of the number of patients a nurse
has, how busy they are, etc. Performing hand hygiene should be done before entering a patient’s
room and when leaving. Using hand sanitizer, in most cases, is acceptable. Some exceptions to
this would be patients on precautions, such as C. diff or COVID, when the nurse has visibly
soiled hands, or if it has been a while since the nurse has washed their hands. Hand sanitizer
does a good job of killing germs and it is good to use when going in between patient’s rooms, but
hand sanitizer should only be used so many times before hand washing should be performed and
certain bacterias/viruses are not killed by hand sanitizer, which can then lead them to be spread
to another patient. Practicing good hand hygiene has been a constant topic in the healthcare field
and has needed even more attention now that there are fewer nurses and COVID patients are in
the hospitals. One way to combat poor hand hygiene and make sure nurses and hospital staff are
performing hand hygiene is electronic hand hygiene monitoring with prompting devices. Having
a device like this can help nurses be more on top of performing hand hygiene and can help
prevent the spread of infection from one patient to another or from the patient to the nurse.
Electronic hand hygiene monitors are already being used in some hospitals and are
currently in use at Bayhealth hospital. The monitors, by Ecolab, are small and can be attached to
a badge reel. The sensor inside of the monitor connects with the sensors inside of the hand
sanitizers or hand soap dispensers. When the sanitizers/soaps are used the light on the monitor
turns green. If the nurse has not performed hand hygiene in a while the monitor will start
beeping and the light color will change to yellow, alerting the nurse that they need to perform
hand hygiene. The hospital itself sets a zone in each patient’s room. When the nurse steps into
that zone without using hand sanitizer, the badge will turn different colors. When the nurse goes
into a patient’s room and does not use hand sanitizer, the monitor beeps and turns yellow. When
the nurse goes into the zone by the patient’s bed and still has not used hand sanitizer, the light on
the monitor will turn red and beep, as well. This also goes for when the nurse leaves a patient’s
room. If the nurse steps out and does not perform hand hygiene, the monitor will beep and turn
yellow. After a period of time still without hand hygiene, the monitor will beep and turn red.
Each time the monitor changes colors or comes into contact with one of the sensors on the
dispensers, the information is sent to Ecolab and a compliance report is formed and sent to the
nurse each week. From this compliance report, the nurse can see what their compliance
percentage is, which they are given a grade for, and what the total percentage of compliance on
their unit is. This report is sent out to make the nurse aware of how compliant they are with
using hand hygiene and shows how they can improve their hand hygiene practices. Using hand
hygiene monitoring can help hospitals as a whole better their hand hygiene practices and protect
patients.
There have been some studies done on hospitals that use hand hygiene monitors and they
have shown that when using these monitors hand hygiene compliance has improved. In one
study published by the Journal of Infection Prevention, they studied healthcare workers in a
hospital setting. “Hand hygiene compliance was in the range of 98-100% during installation and
while using the monitors. Once the system was removed, hand hygiene compliance fell to pre-
installation levels (73%) according to gel usage” (Dyson, Madeo, para. 34). In this hospital
specifically, the rate of compliance improved significantly when the monitors were being used.
Another study done shows that employees were compliant, but this study believes, “hand
hygiene and low-level disinfection compliance is dependent on several personal and nonpersonal
factors. Issues such as time constraints, peer pressure, work culture, available resources, and
understanding of guidelines could influence staff behavior” (Akram, Washburn, para. 39). This
study shows more of a downfall of the monitoring system because not only is hand hygiene
dependent on the person themselves, but also hospital policies and other co-workers. That shows
As said before, the nurse-to-patient ratio has been high, specifically recently, with some
nurses on Med-Surg floors having 6-7 patients in one shift. Between giving medications, giving
patient care, and everything in between, it is possible that the nurse will forget to perform hand
hygiene in between. One downfall of the electronic monitors is the range of them. When the
monitors first came out at Bayhealth, they did not have a good range, meaning unless the nurse
was right in front of the monitor when they used the dispenser, the monitor would not pick up on
the sensor causing the monitor to turn yellow/red when hand hygiene was actually performed.
This led to unnecessary lower compliance reports and to employees getting annoyed at the
monitors. Some medical staff took them off and did not use them properly because they did not
feel that they were working properly. Since then, the complaints about the monitors were told to
the managers on the floors and they were relayed to the people in charge of the monitors. They
have since given new monitors to employees with a better range of the sensors. Now when the
nurse is at the nurse server and they use the hand sanitizer dispenser, they do not have to hold
their badge up to the sensor, it already detects the monitor, and it is recorded as such. Overall,
there has been no research found that has had any major negative downsides to electronic hand
hygiene monitoring.
All hospitals should use this monitoring system because it improves the hand hygiene
compliance rates. Although some healthcare professionals might think this monitoring and the
beeping the monitor makes is annoying, this helps remind the person to wash/sanitize their hands
which prevents the spread of disease to the patients and also to themselves. From the research
found and the personal experience with these monitors, they should be used in all hospitals as a
safety measure because everyone could use a little help bettering their hand hygiene practices.
References
Andrews-Paul, A., Akram, H., & Washburn, R. (2020, June 5). Assessing Hand Hygiene and
https://nursing.jmir.org/2020/1/e18788
Dyson, J., & Madeo, M. (2017, July 4). Investigating the use of an electronic hand hygiene
monitoring and prompt device: influence and acceptability. NCBI. Retrieved December