Isolation status and voice prompts improve hand hygiene

Sandra M. Swoboda, Karen Earsing, Kevin Strauss, Stephen Lane, Pamela A Lipsett

Research output: Contribution to journalArticle

Abstract

Background: Barrier precautions (gowns and gloves) prevent horizontal transmission of pathogens. Nosocomial infections have been linked to poor hand hygiene. Isolation rooms for infection control improve hand hygiene and decrease nosocomial infections. We hypothesized that both patient isolation and electronic hand hygiene prompts incrementally improve hand hygiene of health care workers compared with nonisolation rooms. Methods: A prospective, 14.5-month, 3-phase electronic surveillance study of hand hygiene behavior on an intermediate care unit with 9 patient rooms (3 isolation rooms, 6 nonisolation rooms) was conducted. (phase I: electronic observation, phase II: electronic observation with automated voice messages urging hand hygiene, phase III: electronic observation). Electronic sensors monitored room entries and exits and use of all sinks and all soap dispensers. Phases compared by 2 × 3 Tables, and odds ratios (OR) and 95% confidence intervals (CI) are reported. Results: Phase I (1616 patient-days) health care workers were 49% more likely to wash their hands in isolation rooms versus nonisolation rooms (OR, 1.49; 95% CI: 1.17-1.88). Phase II (1390 patient-days) and phase III (543 patient-days) health care workers were 59% more likely to wash their hands in isolation versus nonisolation rooms (OR, 1.59; 95% CI: 1.17-2.14), P = .001. Conclusion: Health care workers improve hand hygiene when constrained by isolation rooms. Electronic voice prompts further improve hand hygiene behavior. Both physical and auditory reminders improve hand hygiene.

Original languageEnglish (US)
Pages (from-to)470-476
Number of pages7
JournalAmerican Journal of Infection Control
Volume35
Issue number7
DOIs
StatePublished - Sep 2007

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Hand Hygiene
Delivery of Health Care
Odds Ratio
Observation
Confidence Intervals
Cross Infection
Hand
Patient Isolation
Patients' Rooms
Soaps
Infectious Disease Transmission
Infection Control

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases

Cite this

Isolation status and voice prompts improve hand hygiene. / Swoboda, Sandra M.; Earsing, Karen; Strauss, Kevin; Lane, Stephen; Lipsett, Pamela A.

In: American Journal of Infection Control, Vol. 35, No. 7, 09.2007, p. 470-476.

Research output: Contribution to journalArticle

Swoboda, Sandra M. ; Earsing, Karen ; Strauss, Kevin ; Lane, Stephen ; Lipsett, Pamela A. / Isolation status and voice prompts improve hand hygiene. In: American Journal of Infection Control. 2007 ; Vol. 35, No. 7. pp. 470-476.
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