ECJ EUROPEAN Cleaning Journal

Hand hygiene monitoring in hospitals could be significantly reduced without compromising data quality, according to a new US study.

The current standard requiring facilities to collect 200 direct hand hygiene observations per month per patient care unit was first mooted by US not-for-profit watchdog the Leapfrog Group In 2019. It was based on a 2009 World Health Organization hand hygiene observation method.

Meeting the standard has proven challenging for healthcare facilities due to the resources required to gather such a large number of observations. Leapfrog updated the standard in 2021 stating that 100 observations per unit per month would be acceptable if hospitals were to meet all other criteria.

However, a new study published in the American Journal of Infection Control suggests that hospitals could reduce the number of observations to as few as 50 per unit per month without compromising data quality.

Researchers at the Association for Professionals in Infection Control analysed 390,371 hand hygiene observations across 29 facilities within large US hospital systems. They evaluated sample sizes of 25, 50, 100, and 150 observations against the current standard of 200 to determine whether or not there was a statistical difference in adherence.

Analysis revealed that a sample size of 50 observations was comparable to 200 observations for assessing hand hygiene compliance.

"Reducing the number of required observations would alleviate the burden on infection prevention teams and hospitals," said 2024 APIC President Tania Bubb. "It would also enhance the quality of reported data and free up time and resources for meaningful performance improvement. We strongly encourage quality and safety standards organisations to review these data and decrease hand hygiene observation requirements."