Utility of electronic hand hygiene counting devices for measuring physicians' hand hygiene adherence applied to outpatient settings

Am J Infect Control. 2016 Dec 1;44(12):1481-1485. doi: 10.1016/j.ajic.2016.08.002. Epub 2016 Sep 21.


Background: Our objectives were to evaluate the utility of electronic hand hygiene counting devices in outpatient settings and the impact of results feedback on physicians' hand hygiene behaviors.

Methods: We installed 130 electronic hand hygiene counting devices in our redesigned outpatient department. We remotely monitored physicians' hand hygiene practices during outpatient examinations and calculated the adherence rate as follows: number of hand hygiene counts divided by the number of outpatients examined multiplied by 100. Physician individual adherence rates were also classified into 4 categories.

Results: Two hundred and eighty physicians from 28 clinical departments were monitored for 3 months. The overall hand hygiene adherence rate was 10.7% at baseline, which improved significantly after feedback to 18.2% in the third month. Of the clinical departments, 78.6% demonstrated significant improvement in hand hygiene compliance. The change in the percentage of physicians in each category before and after feedback were as follows: very low (84.3% to 72.1%), low (8.6% to 14.3%), moderate (2.9% to 8.9%), and high (4.3% to 4.6%), from the first to third month, respectively. Based on category assessment, 17.1% of physicians were classified as responders.

Conclusions: Physicians' adherence to hand hygiene practices during outpatient examinations was successfully monitored remotely using electronic counting devices. Audit and feedback of adherence data may have a positive impact on physicians' hand hygiene compliance.

Keywords: Compliance; Electronic counting device; Hand hygiene; Monitoring.

MeSH terms

  • Ambulatory Care Facilities*
  • Automation*
  • Behavior Therapy / methods
  • Guideline Adherence / statistics & numerical data*
  • Hand Hygiene / methods*
  • Health Services Research / methods*
  • Humans
  • Management Audit / methods*
  • Physicians*