Automated hand hygiene compliance system's audible alert reminder increases healthcare worker hand hygiene compliance.

OBJECTIVE: To evaluate the effectiveness of an automated hand hygiene compliance system (AHHCS) audible alert and vibration for increasing hand hygiene compliance. DESIGN: A nonrandomized, before-and-after, quasi-experimental study of an AHHCS was implemented in several inpatient units. Over a 51-day period, the system's real-time audible alert was turned on, off, and back on. Overall, hand hygiene compliance was compared between days with activated and deactivated alerts and vibration. SETTING: This study was conducted at a level 1 trauma center, a regional academic health system with 1,564 beds. PARTICIPANTS: The AHHCS was implemented in 9 inpatient units: 3 adult medical-surgical step-down units, and 6 adult intensive care units. The AHHCS badges were assigned to patient care assistants, registered nurses, physical therapists, occupational therapists, speech therapists, respiratory therapists, and physicians. INTERVENTION: In the 9 inpatient units, selected healthcare staff were issued wearable badges that detected entry into and exit from a patient room. The audible alert was turned on for 16 days, turned off for 17 days, and then turned back on for 18 days, for a total of 51 days. RESULTS: Utilization of the AHHCS real-time audible alert reminder resulted in sustained HH compliance ≥90%. When the alert and vibration were deactivated, HH compliance dropped to an average of 74% (range, 62%-78%). Once the alert resumed, HH compliance returned to ≥90%. CONCLUSION: Utilization of an AHHCS with real-time reminder audible alerts may be an effective method to increase healthcare worker HH compliance to ≥90%. Users of AHHCSs should consider the use of real-time reminders to improve HH compliance.

Family presence in the adult burn intensive care unit during dressing changes.

OBJECTIVES: To improve communication, discharge readiness, and satisfaction of burn patients and their families. METHODS: In March 2009, the burn intensive care unit at University of Louisville Hospital, Louisville, Kentucky, incorporated family presence during dressing changes. Adverse family events during observation, measures of patient- and family-centered care according to a standardized patient satisfaction survey, infection rates, and staff members' response to the intervention were tracked. RESULTS: Through December 2011, no adverse family events occurred, patients' satisfaction scores increased, and infection rates did not increase. Staff members responded positively to the project. CONCLUSIONS: Allowing family presence during dressing changes provides an opportunity to educate and include patients' family members in care delivery.