Hand hygiene in neonatal care

Good hand hygiene compliance, i.e. regular hand washing according to protocol, is essential to prevent infections in healthcare settings. To measure how well hospital workers comply to good hand hygiene is difficult. Direct observation of hand hygiene compliance is the gold standard but is time consuming, and thus expensive; furthermore, observations are an intervention in itself and may thus give biased result of true compliance to hand hygiene protocol. An electronic dispenser for hand alcohol with built-in wireless recording equipment allows continuous monitoring of its usage. 
The purpose of a study we conducted that was just published in BMC Infectious Diseases was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations.

In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.