Many organizations including the Joint Commission, APIC, SHEA and The Leapfrog Group have guidelines and recommendations for hand hygiene compliance in acute care hospitals. Among them, The Leapfrog Group has established a leadership position by developing best practices for hospital hand hygiene (HH). Those practices are integrated into their evolving Hand Hygiene Standard with five performance domains hospitals must meet:
- Training and education
This column focuses on compliance monitoring, but getting hand hygiene right requires meeting the performance criteria for all five domains. We’ll consider inpatient units in acute-care hospitals here, but similar principles would apply to emergency departments and outpatient units.
Many infection preventionists and C-suite leaders choose between the two main options for compliance measurement—either direct observation or a validated electronic compliance monitoring system that captures both hand hygiene opportunities (HHOs) and events (HHEs).
The evidence suggests1,2 that hospitals use direct observation for coaching and intervention—identifying and removing hand hygiene barriers.
Studies also show that combining electronic monitoring for measurement and direct observation for coaching and intervention can achieve significant compliance improvement.3
But when it comes to accurate, reliable and cost-effective measurement, which makes more sense?