-- Irisys Technology Aims to Enhance Hand-Hygiene Compliance by Cutting Subjectivity
And Human Error from the Monitoring Process --
ATLANTA (June 10, 2013) – Infrared technology could be a key strategy to improving healthcare workers’ hand-hygiene compliance – and a high-tech weapon in helping to reduce the spread of healthcare-acquired infections (HAIs), according to the results of a trial in a U.K.-based general medical unit.
The study of the Irisys Intelligent Handwash Monitoring System was supported by the National Institute for Health Research (NIHR), which commissions research in the U.K. on behalf of the Department of Health and National Health Service.
“Accuracy is key to gauging the effectiveness of hand-hygiene intervention strategies,” says Anne Macmillan, business development director for Irisys Healthcare. “The area of automated compliance monitoring is still new and evolving. Some of the first approaches taken by others have attempted to use generalized averages – instead of measuring behavior derived from the actual environment being monitored – and therefore exclude significant groups that should be counted as part of their studies. The Intelligent Handwash Monitor’s smart-sensor technology, however, yields unbiased, objective data that drives informed decision making. Both opportunities and actual events are crucial to illustrate the complete hand-hygiene picture.”
The technology helps to monitor healthcare workers’ behavior in relation to the World Health Organization’s Five Moments for Hand Hygiene and is designed to eliminate the potential for bias, assumption and error. Rather than relying solely on human observation or generalized averages, it utilizes unobtrusive smart-sensor technology to establish baseline compliance; monitor workers’ behavior in response to intervention-strategy implementation; and report outcomes. A trial using the technology was conducted in three key phases over 12 weeks:
Smart sensors installed at the unit’s entrance captured footfall, or the number of workers and visitors entering and leaving, as well as handwash/hand-sanitizing “opportunities” versus actual handwash/hand-sanitizing “events.” All persons entering and exiting the unit entrance were required to carry out hand-hygiene. Human observers also audited hygiene opportunities and sanitizer events. These datasets facilitated the development of intelligent software algorithms.
Optimized equipment and detection algorithms captured datasets that were again audited by human observers. These independent datasets verified the system’s accuracy.
A 12-week period (three consecutive, four-week intervals) validated the system’s ability to measure a baseline – and subsequently the effect of an intervention – and how an intervention was sustained. A four-week monitoring period established baseline compliance – followed by four weeks of positive feedback delivery in the form of visual message stimuli that bolstered proper handwashing and hand-sanitizing protocol. The longevity of individuals’ observed changes was investigated for four weeks after visual stimuli were removed.
The study found – in this specific environment – individuals improved critical hand-hygiene compliance by 73 percent just one week after visual cues prompting proper and frequent handwash and sanitizer practices were placed at the entrance the general medical unit. Compliance returned to the average baseline of 23 percent three weeks after the visual stimuli were removed.
Throughout the study, the system monitored opportunities to use hand-sanitizer dispensers – and compared them to actual usage of dispensers – to determine daily compliance, achieving 95 percent accuracy. Results based on 45,108 subjects and 13,406 hygiene events found:
- Average baseline compliance of 23 percent;
- Overall average compliance improved 57 percent during the intervention period;
- Greatest compliance increase when feedback was new – with average daily compliance rising by 73 percent the week immediately following the introduction of visual stimuli;
- Compliance returned to baseline levels just three weeks after visual stimuli were removed;
- Compliance varied daily and weekly – particularly on weekends; and
- Sanitizing gel compliance was noticeably lower during weekends – but increased during the intervention period.
“This study shows infrared technology could have a tremendous effect on how healthcare facilities look to help reduce the spread of infections that can transmit from worker to patient – or vice versa – if correct hand-hygiene is not practiced,” says Dr. Frank Miskelly, Imperial College London. “The technology could also enable a more easily adoptable and promotable system-wide, team approach to a patient-safety culture.”
While additional trials of the technology will be conducted, preliminary findings have already given some insight into potential HAI-reduction strategies which should be part of a sustained and adaptive intervention program. In addition to wide-scale deployment to give clinical managers the data to target and evaluate interventions, the system could be an asset for research teams investigating behavioral change.
“Results suggest visual stimuli can raise hand-hygiene compliance, but those stimuli need to be maintained and contain variety to sustain improvements,” Dr. Miskelly says. “Many trials that rely solely on direct human observation have been conducted at facilities and – due to the Hawthorne Effect – are well known to influence human behavior. We expect specific feedback to workers on their true performance would further raise compliance, but additional studies are required to confirm this theory.”
Irisys Hand Hygiene Compliance research has been supported by the National Institute for Health Research’s (NIHR) Invention for Innovation (i4i) program to help provide a solution to drive improvements in hand hygiene. The views expressed with reference to the findings of this independent research are those of Irisys and not necessarily those of the NHS, the NIHR or the Department of Health.
Irisys is a global innovator in award-winning technologies that make a significant, measurable impact on business efficiency and improve the quality of people’s lives. Irisys is the global leader in people counting technologies and real-time checkout management solutions. Its infrared thermal monitoring solutions are used by some of the world’s leading retailers to boost customer service, operational efficiency and profitability. Irisys pioneered the introduction of low-cost thermal imaging cameras for industrial applications, and its security technologies are predicted to transform the intruder detection market. Irisys healthcare solutions aim to make hospitals safer and cleaner, and improve home monitoring for the elderly and infirm. Learn more at www.irisys.net.
About the NIHR
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programs, centers of excellence, and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).