Research for infection protection

Interview: “This data quality also convinces chief physicians”

Brigitte Rüstau, Infection Control Nurse, Medizin Campus Bodensee GmbH, Germany
Brigitte Rüstau, Infection Control Nurse, Medizin Campus Bodensee GmbH, Germany

Three questions to Brigitte Rüstau, Infection Control Nurse, Medizin Campus Bodensee GmbH, Germany.


Hygiene and infection protection become increasingly important for clinics and even relevant to their budget. Can an app help to fulfil legal requirements?

When we talk about infection control, hand hygiene plays a key role. And when we want to improve hand hygiene, a key factor is the observation and feedback of hand hygiene behaviour. The World Health Organization (WHO) even considers it the gold standard. In Germany, hand hygiene compliance monitoring was added to the indicator set of the quality assurance procedure “Preventing nosocomial infection: surgical site infection” of the German Institute for Quality Assurance and Transparency in Health Care (IQTiG). So far, we had done the observations with tally sheets and tables, which had been quite time and labour-intensive. For some months, we have been testing a digital solution to record compliance. With this Observe App we can conduct a lot more observations than before. The German “Aktion Saubere Hände” (Clean Hands Campaign) for example recommends observing 200 indications per ward and functional area – that seemed impossible before.


High data volumes do not necessarily mean a gain in knowledge. How is quantity turned into quality?

Due to the time saving, we can conduct many more observations and collect a lot more data. Thus, we are able to draw a more realistic picture of our facility’s hygiene standard. We do not only have a snapshot, but valid results. This evidence-based information is more credible and more convincing for the clinic management, chief physicians and wards. The evaluation itself is done fully automatically – and does not require special computer skills. As a staff unit directly reporting to the management we are thus able to regularly report results at a high and comparable level, which professionalises our work and improves our standing within the facility – also among chief physicians. In addition, the app facilitates the documentation and communication with authorities. For example, just recently, we observed an accumulation of colonisations – in such a case, additional compliance observations are recommended anyway.
Thanks to the Observe App we could provide the health authority with high-quality hand hygiene data. This generates transparency and trust in the entire facility.


You have tested the application for some months. Has infection control in your facility improved already?

We could observe a direct link between the use of the Observe App, the associated improved feedback to staff and an improved hand hygiene. We were able to enhance the quality of compliance in individual wards. Another interesting point is that we were not only able to detect when hand disinfection is not carried out. We could also observe that many employees disinfect their hands when not required – for example in the corridor when having left a patient room. This indication does not exist. Thanks to the app we record these situations more often now and can give appropriate feedback. So, the application sustainably supports a behavioural change and contributes to patient safety. Also employees and patients reacted positively. Today, tablet computers and smart phones are a matter of course in the private domain. Utilising the digitisation for infection control is modern and contemporary. For a long time, hygiene has not exactly stood for modernity. Such digital means change its image, which is good for infection protection.