Research for infection protection

Abstract: Fully captured: how digital data motivate employees to perform hygiene

Three clinics, 14 competence centres and a total of 34 082 hospitalised patients and almost 65 000 outpatients in 2016: Medizin Campus Bodensee GmbH stands for the linking of medical competences while attaching foremost importance to the quality of patient care. Here, the clinic hygiene plays a significant role and hence is established as staff unit directly reporting to the management. Highest hygiene standards shall for example be guaranteed by surveillance measures: Brigitte Rüstau, Senior Infection Control Nurse and Head of the Hygiene Team, could already establish the participation in the regional quality assurance project MDR pathogens of the Office for Quality Assurance in Hospitals (GeQiK) and in the German “Aktion Saubere Hände” (Clean Hands Campaign) and could implement several modules of the Hospital Infection Surveillance System (KISS) of the German National Reference Centre for the Surveillance of Nosocomial Infections (NRZ).

The continuous collection and evaluation of the hygiene data, as recommended by the World Health Organization (WHO) for the observation of hand hygiene compliance, already is an established element of the clinic hygiene’s quality assurance. In contrast to measuring the consumption of hand disinfectants, the observation of the compliance allows to assess hand hygiene according to qualitative benchmarks. Thus, hygiene experts can check whether hand disinfection is performed correctly and in the right moment and thus whether a high consumption of hand disinfectants involves effective hand hygiene. In order to optimise this important element, in 2017, Brigitte Rüstau and her hygiene team introduced the “Observe” eHealth software as part of a pilot project. The “Observe” eHealth software to digitally record hand hygiene compliance is a professional and modern alternative to conventional, paper-based observation methods.

The compliance monitoring tool was developed by the BODE SCIENCE CENTER, Hamburg, Germany, and allows a mobile and simple recording of the compliance. By being linked to the surveillance module HAND-KISS of NRZ, the “Observe” app offers a comprehensive picture of the hand hygiene status in the facility: quantitatively through the measurement of the hand disinfectant consumption and qualitatively through the indication-specific evaluation of the hand hygiene compliance. The evaluation is done automatically at the touch of a button – the time- consuming transmission of the data to an Excel file is not necessary anymore. The result: a high quality of data that provide a clear picture of the compliance in a ward – without incidental findings. The professional presentation convinces – both the hygiene commission and senior physicians. The reason: the precise evaluation of high data volumes, based on the “5 Moments for Hand Hygiene” additionally allows to detect compliance barriers and tackle them in a targeted manner.

Already after a few months, the hygiene team could achieve first successes, as they were able to reveal first barriers to compliance thanks to the increased number of observations and the detailed evaluation. For example, the observation in one ward obtained low compliance rates for the hand disinfection after contact with the immediate patient surroundings. The employees considered touching the bedside table and the patient bed as harmless, although it is indicated to disinfect the hands after contact with the immediate patient surroundings. Also unnecessary hand disinfection procedures, for example in the corridor after having left the patient room, could be observed.

“Fully captured: how digital data motivate employees to perform hygiene”. Speech by Brigitte Rüstau, Infection Control Nurse, Medizin Campus Bodensee GmbH, Germany held at the Lunchtime Symposium “Digital infection control: Enhancing patient protection by eHealth”, Berlin, 12 October 2017, arranged by the BODE SCIENCE CENTER, Hamburg, scientific centre of excellence of PAUL HARTMANN AG, Heidenheim.