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Tech helps facility slash HAIs by 22%
Staff demonstrate 'team spirit' for initiative
Princeton Baptist Medical Center in Birmingham, AL, was recently chosen as one of two national HIMSS/ASQ Stories of Success for the 22% reduction in healthcare-associated infections (HAIs) resulting from their adoption of a radio frequency identification (RFID)-based hand-hygiene monitoring system.
Applying the new technology was part of an ongoing effort to reduce infections, notes Gloria Deitz, RN, nurse manager for the post-op surgical unit, where the system was piloted. "We were monitoring our UTI's (urinary tract infection), our respiratory infections, and had some initiatives going along those lines involving assessment, and some initiatives on our processes and how to collect specimens," she says.
The new technology, provided by Proventix, began installation in February 2010. It's difficult to measure the actual improvement in hand-washing compliance that was achieved, says Deitz, because prior to that, "We had to do it manually using spot audits, so you're not really comparing apples to apples."
When the system was installed, the hospital had monitors placed in every patient room and in the hallways. The monitors were mounted along with hand-washing solution dispensers. Staff members were given tags, so the system could detect who was entering the room and whether they were washing their hands. "It also knows when you leave, and how many times you have used the system," Dietz adds.
In the first month, there were about 3,000 hand-hygiene attempts, she continues. "By December, the attempts had increased to over 45,000."
Staff buys in
Deitz says her approach with staff was not intrusive. "We explained the tags, and what the system would do, but stressed we were not installing a 'watchdog' system," she shares. "The staff just bought into it. As they saw their attempts go up, we saw our infection rate go down."
One of the key factors in this success, says Deitz, was providing the staff with frequent feedback on where they were compared to the previous year. The main vehicle was monthly unit meetings; in addition, she says, the vendor worked with infection control nurses and provided feedback on the progress that was being made. "The nurses wanted to know how they were doing, and as they saw the numbers going up it reinforced the importance of hand hygiene," Deitz explains.
She says that so far she has not had to single out individuals who were non-compliant. "Once they see the reports and they know, 'Hey, that's me,' it's like a competition," she explains. "Right now we do it as a group effort. We can pull up the individual if we need to or want to, but the attitude is 'We're working together to reduce infections, and this is what we need to do.' If I noticed that someone was not ever washing, I'd go to them and say 'I don't see you doing this,' and that would be all it would take."
Going beyond technology
Deitz notes that technology in and of itself will not accomplish quality improvement goals. "One of the keys is to let the nurses know how many infections you have on your unit," she says. "We even drill down to what we think is the cause and what you can do to prevent it from happening again. So, for example, we examine processes, techniques, and environmental conditions."
If you are considering adopting a hand hygiene monitoring system, she continues, "Involve the staff by letting them be in on the front end from the start. Let them know what you want to do and why. Also, explain that this is not a punitive move, but something designed to improve patient care and give quality care to patients. All nurses believe that to the core; they want to give the best possible care. This system is just a piece of technology that can help you with the process."