FEATURE ARTICLEAutomated Monitoring A Potential Solution for Achieving Sustainable Improvement in Hand Hygiene PracticesLEVCHENKO, ALEXANDER I. PhD, PEng; BOSCART, VERONIQUE M. PhD, RN; FERNIE, GEOFF R. PhD, PEng Author Information Author Affiliations: Toronto Rehabilitation Institute–University Health Network (Drs Levchenko and Fernie), Toronto; Conestoga College (Dr Boscart), Kitchener; and Department of Surgery (Dr Fernie), University of Toronto, Ontario, Canada. Equipment and space have been funded with grants from the Canada Foundation for Innovation, Ontario Innovation Trust, and the Ontario Ministry of Research and Innovation. There is a potential conflict of interest because of the anticipated commercialization of the hand hygiene monitoring system. This intellectual property is patent protected. Any future royalties generated will be distributed according to the policy at Toronto Rehabilitation Institute. Drs Levchenko and Fernie are inventors of the technology who may benefit from royalties in the future. Corresponding author: Alexander I. Levchenko, PhD, PEng, TRI-UHN, 550 University Ave, Toronto, ON, Canada M5G 2A2 ([email protected]). CIN: Computers, Informatics, Nursing: August 2014 - Volume 32 - Issue 8 - p 397-403 doi: 10.1097/CIN.0000000000000067 Buy Metrics Abstract Adequate hand hygiene is often considered as the most effective method of reducing the rates of hospital-acquired infections, which are one of the major causes of increased cost, morbidity, and mortality in healthcare. Electronic monitoring technologies provide a promising direction for achieving sustainable hand hygiene improvement by introducing the elements of automated feedback and creating the possibility to automatically collect individual hand hygiene performance data. The results of the multiphase testing of an automated hand hygiene reminding and monitoring system installed in a complex continuing care setting are presented. The study included a baseline Phase 1, with the system performing automated data collection only, a preintervention Phase 2 with hand hygiene status indicator enabled, two intervention Phases 3 and 4 with the system generating hand hygiene reminding signals and periodic performance feedback sessions provided, and a postintervention Phase 5 with only hand hygiene status indicator enabled and no feedback sessions provided. A significant increase in hand hygiene performance observed during the first intervention Phase 3 was sustained over the second intervention Phase 4, with the postintervention phase also indicating higher hand hygiene activity rates compared with the preintervention and baseline phases. The overall trends observed during the multiphase testing, the factors affecting acceptability of the automated hand hygiene monitoring system, and various strategies of technology deployment are discussed. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.