Light-guided nudging and data-driven performance feedback improve hand hygiene compliance among nurses and doctors

Iversen, Anne-Mette; Stangerup, Marie; From-Hansen, Michelle; Hansen, Rosa; Sode, Louise Palasin; Kostadinov, Krassimir; Hansen, Marco Bo; Calum, Henrik; Ellermann-Eriksen, Svend; Knudsen, Jenny Dahl

BACKGROUND: Evidence-based practices to increase hand hygiene compliance (HHC) among healthcare workers are warranted. We aimed to investigate the effect of a multimodal strategy on HHC. METHODS: During this 14-months prospective, observational study, an automated monitoring system was implemented in a 29-beds surgical ward. Hand hygiene opportunities and alcohol-based hand rubbing events were measured in patient and working rooms (medication, utility, storerooms, toilets). We compared baseline HHC of healthcare workers across periods with light-guided nudging from sensors on dispensers and data-driven performance feedback (multimodal strategy) using the Student's t-test. RESULTS: The doctors (n=10) significantly increased their HHC in patient rooms (16% vs. 42%, p<0.0001) and working rooms (24% vs. 78%, p=0.0006) when using the multimodal strategy. The nurses (n=26) also increased their HHC significantly from baseline in both patient rooms (27% vs. 43%, p=0.0005) and working rooms (39% vs. 64%, p<0.0001). The nurses (n=9), who subsequently received individual performance feedback, further increased HHC, compared with the period when they received group performance feedback (patient rooms: 43% vs. 55%, p<0.0001 and working rooms: 64% vs. 80%, p<0.0001). CONCLUSIONS: HHC of doctors and nurses can be significantly improved with light-guided nudging and data-driven performance feedback using an automated hand hygiene system.