The Intersection of Hand Hygiene, Infusion Pump Contamination, and High Alarm Volume in the Health Care Environment

Am J Infect Control. 2020 Apr 16;S0196-6553(20)30207-8. doi: 10.1016/j.ajic.2020.04.006. Online ahead of print.


Background: Researchers have found that lack of hand hygiene and environmental contamination are sources of infection transmission in the health care environment. One factor that may lead to lack of hand hygiene is alarm fatigue, the sensory overload that results when clinicians are exposed to an excessive number of alarms, causing them to silence alarms without taking proper precautions. In this study, we report hand hygiene compliance and infusion pump contamination in the context of infusion pump alarm prevalence.

Methods: Health care worker hand hygiene audits were conducted to determine percent compliance. Cultures were obtained from infusion pumps to determine environmental contamination. The frequency of alarms from August 4, 2019 to September 7, 2019 was determined.

Results: Hand hygiene compliance ranged from 50% to 87%. Pump contamination ranged from 20% to 70% per unit. A total of 116, 872 infusion pump alarms sounded in the hospital.

Discussion: Pumps were contaminated primarily with skin flora. This was demonstrated in the context of poor hand hygiene compliance and a high number of alarms, indicative of alarm fatigue.

Conclusions: The intersection of a high prevalence of infusion pump alarms and poor hand hygiene resulting in bacterial contamination of pumps could be a source of health care-associated infection transmission for patients.

Keywords: Alarm fatigue; Environmental contamination; Hand hygiene compliance; Health care-associated infection.