Top Barriers to Hand Hygiene: Empty Dispensers and Lack of Reminders

Have you ever been frustrated by an empty sanitizer dispenser when you have wanted to wash your hands? Would reminders to wash your hands be helpful during the course of a busy shift?

Empty sanitizer dispensers and a lack of real-time feedback and coaching about hand hygiene can be major barriers to hand hygiene compliance, according to survey results presented at the Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference (Ward, 2022).

Conducted by investigators at three Advocate Health Care facilities in Illinois, the survey was developed to learn why health care worker hand hygiene compliance remains low nationwide.

Among the 1,001 health care workers who completed the survey, 92% responded that hand hygiene was “very effective” at preventing infections among patients and staff, and 93% said they would be receptive to reminders to perform hand hygiene. However, less than half of the workers surveyed said they would “always” personally provide these reminders to team members.

Hand hygiene compliance improved at two of the three facilities after they implemented interventions to improve the availability of sanitizer, encourage peer-to-peer reminders, and supplement “secret shopping” auditing with real-time feedback and coaching.

Vitalacy’s automated hand hygiene solution monitors dispenser use, provides real-time hand wash reminders and coaching

Many healthcare organizations have made commendable progress toward improving their hand hygiene compliance. However, using secret shoppers, also known as direct observation, to audit health care workers’ compliance can be expensive and inaccurate.

A study of direct observation practices at 10 acute care hospitals found that they completed only 10 to 30 observations per unit per month (Livorsi, et al., 2018). Contrast this low number of observations with the 100 to 200 observations per unit per month required by the Leapfrog Group’s 2022 hand hygiene standards for its hospital and ambulatory surgery center survey. The standards also require observations to occur across all days of the week and all shifts in proportion to care providers who interact with patients.

Ramping up a direct observation program to achieve more observations per unit per month would require more budget to hire and manage more observers for most hospitals. Assuming a budget of $40/hour for direct observation and six observations an hour, per the industry average of 10 minutes per observation, an increase from 24 to 100 to 200 observations a month results in costs going from $160 to $680 to $1,360 per unit per month. Multiply that by the number of units and costs quickly become unsustainable. And these figures only count the costs of observers recording hand hygiene compliance results, not the costs of recruiting and training the observers and other expenses.

Direct observation results are inaccurate for two main reasons – the Hawthorne effect, which is the tendency for a person to modify their behavior while being observed, and the low and misrepresented numbers of hand hygiene opportunities measured by most direct observation programs.

Vitalacy’s dispenser sensors track how often and when your dispensers are being used for hand washing. This monitoring of hand sanitizer and soap usage also better enables you to make sure refills are completed and supplies are ordered on time. These small, lightweight sensors adhere to virtually any kind of manual or automatic dispenser for hand sanitizer or soap.

Vitalacy’s SmartBand wearable delivers real-time, private vibration hand wash reminders to the care provider’s wrist at the point of care. The SmartBand is the only solution on the market that monitors and coaches on wash duration. Vitalacy’s experience with St. Mary’s Healthcare System for Children in Queens, New York, showed a correlation between longer hand wash duration and reduced healthcare-acquired infections (Vitalacy Case Study).

The ability to track the quality of each hand wash is a primary differentiator of the SmartBand. Accelerometers within the wristband monitor hand movements during the hand wash. When the care providers wash their hands, these observational data are fed into a proprietary algorithm that identifies the proper hand-washing sequence. These data enable the wristband to provide feedback to its wearer on how to improve hand-washing technique, including flashing a “wash too short” icon if the hands do not articulate long enough after a dispense event.

Providing real-time reminders at the point of care is a pivotal step in increasing and sustaining patient safety and hand hygiene compliance. Communicating with each other via low-power Bluetooth technology, the patented dispenser sensors and wearables work together at the point of service to remind caregivers and drive up compliance rates.

Request a demo today to learn more about the Vitalacy Automated Hand Hygiene Monitoring Solution.