Do peer effects improve hand hygiene adherence among healthcare workers?

Mauricio N Monsalve; Sriram V Pemmaraju; Geb W Thomas; Ted Herman; Alberto M Segre; Philip M Polgreen

doi:10.1086/678068

Back

Do peer effects improve hand hygiene adherence among healthcare workers?

Journal article

Open access

Peer reviewed

Do peer effects improve hand hygiene adherence among healthcare workers?

Mauricio N Monsalve, Sriram V Pemmaraju, Geb W Thomas, Ted Herman, Alberto M Segre and Philip M Polgreen

Infection control and hospital epidemiology, Vol.35(10), pp.1277-1285

10/2014

DOI: 10.1086/678068

PMCID: PMC5508553

PMID: 25203182

View Online

Abstract

To determine whether hand hygiene adherence is influenced by peer effects and, specifically, whether the presence and proximity of other healthcare workers has a positive effect on hand hygiene adherence. An observational study using a sensor network. A 20-bed medical intensive care unit at a large university hospital. Hospital staff assigned to the medical intensive care unit. We deployed a custom-built, automated, hand hygiene monitoring system that can (1) detect whether a healthcare worker has practiced hand hygiene on entering and exiting a patient's room and (2) estimate the location of other healthcare workers with respect to each healthcare worker exiting or entering a room. We identified a total of 47,694 in-room and out-of-room hand hygiene opportunities during the 10-day study period. When a worker was alone (no recent healthcare worker contacts), the observed adherence rate was 20.85% (95% confidence interval [CI], 19.78%-21.92%). In contrast, when other healthcare workers were present, observed adherence was 27.90% (95% CI, 27.48%-28.33%). This absolute increase was statistically significant (P < .01). We also found that adherence increased with the number of nearby healthcare workers but at a decreasing rate. These results were consistent at different times of day, for different measures of social context, and after controlling for possible confounding factors. The presence and proximity of other healthcare workers is associated with higher hand hygiene rates. Furthermore, our results also indicate that rates increase as the social environment becomes more crowded, but with diminishing marginal returns.

Guideline Adherence - statistics & numerical data

Hand Hygiene - standards

Hand Hygiene - statistics & numerical data

Hospitals, University - statistics & numerical data

Humans

Medical Staff, Hospital - psychology

Medical Staff, Hospital - statistics & numerical data

Nursing Staff, Hospital - psychology

Nursing Staff, Hospital - statistics & numerical data

Peer Group

Personnel, Hospital - psychology

Personnel, Hospital - statistics & numerical data

Details

Title: Subtitle: Do peer effects improve hand hygiene adherence among healthcare workers?
Creators: Mauricio N Monsalve - University of Iowa
Sriram V Pemmaraju - University of Iowa
Geb W Thomas - University of Iowa
Ted Herman - University of Iowa
Alberto M Segre - University of Iowa
Philip M Polgreen - University of Iowa
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.35(10), pp.1277-1285
DOI: 10.1086/678068
PMID: 25203182
PMCID: PMC5508553
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Grant note: K01 AI75089 / NIAID NIH HHS K01 AI075089 / NIAID NIH HHS
Language: English
Date published: 10/2014
Academic Unit: Infectious Diseases; Epidemiology; Orthopedics and Rehabilitation; Industrial and Systems Engineering; Nursing; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Computer Science; Internal Medicine
Record Identifier: 9984187060502771

Metrics

11 Record Views

45 Times Cited - Web of Science

See more details