Device reminds health workers to wash hands
Published Monday, March 3, 2008 1:13PM EST
Getting health care workers to remember to wash their hands is seen as key to stopping the spread of superbugs. Now, Canadian researchers have developed a system they believe could keep doctors and other health workers on their toes.
The simple system, developed by a team at Toronto Rehab, uses electronic sensors over the patient's bed to detect whether health workers have washed their hands. If they haven't, it signals a device worn around the worker's neck to issue a "beep'' as a reminder. The system also includes a supply of alcohol disinfectant for those times when soap and water isn't within reach.
The researchers hope the system will cut rates of hospital-acquired infections. Geoff Fernie, vice-president of research at Toronto Rehab, notes that each year in Canada about 8,000 patients die from hospital-acquired infections. That's about 22 patients a day. As many as half of those deaths can be attributed to poor hand cleaning.
"Worldwide, there are about 50,000 people a year being killed because of poor hand hygiene. It's something we have to stop," he told CTV News.
Even though diligent hand hygiene is known to significantly cut the transmission of infections between patients, studies have shown that health-care workers often fail to do so. Most hospitals have tried many strategies to raise awareness among health care workers about the importance of handwashing -- from educational seminars to poster campaigns.
In almost every instance, hand-washing compliance usually rises initially, but over time tends to slip back again. That's not because health workers don't understand that hand hygiene can help stem the spread of superbugs such as MRSA (methicillin-resistant Staphylococcus aureus), C. difficile, E. coli and strains of viral influenza; it's simply a matter of having a lot on their minds.
"When you are busy, disinfecting your hands every time you have contact with a new patient is very difficult to sustain over time," says Veronique Boscart, a Toronto Rehab nurse and researcher who worked on the system's first pilot study.
Fernie says he's sympathetic.
"A busy nurse will have to wash her hands 60-70 times an hour in a busy hour. So it's not at all surprising that human beings would forget to do it sometimes," says Fernie. "So we need to help them."
Fernie says what his team has created is quite simple. Health care workers wear a sensor on a rope around their necks. An electronic monitoring system running along a track on ward ceilings takes note of when a worker stops at a patient's bed.
When they move on and stop again at another bed, if they have not used the alcohol gel dispenser that is attached at their waists or have not stopped at a sensor-equipped sink or a wall-mounted gel dispenser to wash their hands, the system will beep, reminding the worker to disinfect their hands.
The device also keeps track of your compliance rate, which you can then download to note your handwashing history. Fernie said the data collection is not meant to be used by supervisors to monitor their staff, but rather a means of showing each worker if their handwashing hygiene is waning over time.
"I was worried early on that there is an element of 'Big Brother'-creepy element that you know where people are and what they are doing," he says. But Fernie said his team found in their pilot studies that staff actually appreciated the system.
But Dr. Allison McGeer, director of Infection Control at Mount Sinai Hospital who is on the team developing the system, says the health care workers who have tried it like it and so does she.
"It lets me focus on the task I am doing with the patient, but it flags me when it wants me to do something that it doesn't want me to think about," she explained to CTV.
"You can think about it like the alarm for the seatbelt in your car."
Fernie believes his system won't allow for hygiene compliance rates to dwindle over time.
"Maybe, for the first time, we might be able to make a sustainable improvement in the rates of handwashing," he says.
The system will undergo further testing starting this summer in hospital settings. Over the next two years, two wards at St. Michael's Hospital in Toronto and two at Toronto Rehab will be designated as test sites.
Then, the research team plans to develop with a commercial partner. If all goes well, the system should be on the market within two years, at an estimated cost of $300 per bed.
McGeer says she initially thought that sounded expensive when you calculate how many beds there are in a hospital. But she believes, it in the end, it will actually save hospitals money.
"If it works to significantly improve hand hygiene, $300 is nothing. You don't have to make a big difference in hospital-acquired infection rates to save a very large amount of money. So, if it reduces infections, it will make a dramatic difference in costs."
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip