Investigating the use of an electronic hand hygiene monitoring and prompt device: influence and acceptability

Introduction: Hand hygiene (HH) prevents the transmission of healthcare-associated infections. Electronic HH monitoring and prompt devices have been developed to overcome problems with monitoring HH and to improve compliance. Devices monitor room entry and exit and soap use through communication between ceiling sensors and badges worn by practitioners and the badges sense alcohol rub. Objectives: To investigate (1) the impact of devices on HH compliance, (2) how devices influence behaviour and (3) the experience and opinions of practitioners on the use devices. Methods: HH compliance was monitored (before, during and after system installation) by observations and alcohol rub usage. Compliance during installation was also monitored by the device. Healthcare practitioner interviews (n = 12) explored how the device influenced behaviour and experiences and opinions of wearing the device. Results: HH compliance improved during the period the device was installed. Practitioners reported the device increased their awareness, enhancing their empathy for patients and encouraged patients and colleagues to prompt when HH was needed. Practitioners’ reported better HH, gaming the system and feelings of irritation. Conclusion: HH prompt and monitoring systems seem to improve compliance but improvements may be undermined by practitioner irritation and system gaming