An electronic hand hygiene monitoring system may improve hand hygiene adherence and reduce the risk for hospital-acquired infections (HAIs) among health care workers (HCWs). These study results were published in the Journal of Hospital Infection.

This long-term follow-up study was conducted between July 18 and June 2022 among HCWs employed at a nephrology department in Europe. Researchers assessed the effects of 2 feedback interventions for hand hygiene adherence on preventing hospital-acquired bloodstream infections (HABSIs) and hospital-acquired urinary tract infections (HAUTIs). Data on HAI incidence were collected 2 years before (control period) and 2 years after implementation of an electronic hand hygiene monitoring system. Differences in infection incidence between the 2 periods were evaluated via log-rank testing. Data compiled from the monitoring system were provided to HCWs in both individual and group sessions.

There were 181 HCWs included in the analysis, of whom 142 were caregivers and 39 were physicians. Baseline hand hygiene adherence rates were higher among caregivers vs physicians (40% vs 22%; P <.001), though increased rates were observed among both groups when feedback on hand hygiene was provided in group sessions.

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The researchers found that feedback received in group sessions resulted in the highest increase in hand hygiene adherence rates among HCWs with low to moderately-low baseline adherence rates. However, feedback provided in individual sessions among the same group of HCWs was associated with lowest improvement in hand hygiene rates.

In regard to incident HABSI diagnoses, rates were significantly reduced in the intervention period (4 per 10,000 patient-days; 95% CI, 2-11) compared with the control period (14 per 10,000 patient days; 95% CI, 9-21). However, the rate of HAUTI diagnoses did not significantly differ between the intervention (35 per 10,000 patient days; 95% CI, 22-42) and control (36 per 10,000 patient-days; 95% CI, 28-47) periods.

“[W]e found that the overall HHC [hand hygiene compliance] improvements on ward level were driven by a collective effort and not by a few high performers,” the researchers noted.

Limitations of this study include the small sample size, the observational design, and potentially insufficient data. In addition, hand hygiene was not monitored outside designated zones within the hospital.

According to the researchers “This study is important because it helps us understand the patterns of individual HHC in response to interventions.”

Disclosure: Some authors declared affiliations with industry. Please see the reference for a full list of disclosures.


Knudsen AR, Hansen MB, Møller JK. Individual hand hygiene improvements and effects on healthcare-associated infections: a long-term follow-up study using an electronic hand hygiene monitoring system. J Hosp Infect. Published online March 17, 2023. doi:10.1016/j.jhin.2023.02.017

This article originally appeared on Infectious Disease Advisor