Leveraging Agents of Change to Improve the Use of an Electronic Hand Hygiene Monitoring System.

Abstract

Objective: We evaluated the effectiveness of an "agents of change" intervention in enhancing hand hygiene compliance (HHC) with an electronic hand hygiene monitoring system (EHHMS), and improving perceptions of the EHHMS among healthcare workers.

Intervention: Two intervention units and one control unit were selected. Thirteen agents received training, then worked independently on the intervention units to improve their colleagues' perceptions and behaviors toward the EHHMS. Agents and unit healthcare workers were surveyed before and after the intervention to measure perceptions of the EHHMS and impact of the intervention. HHC was electronically monitored across all units 8 weeks before, 5 weeks during, and 8 weeks after the intervention.

Results: Post-intervention, 70% of agents believed they influenced their colleagues' behaviors, but 50% felt they changed attitudes. Unit level surveys confirmed minimal change in attitudes and culture. Average HHC rates increased by 6.8% and 5% in the intervention units during the intervention (both p <0.01), whereas the control did not. One intervention unit maintained improvement in the post-period, whereas the other returned to baseline. Compliance rates for all units were similar in the post-period.

Conclusion: Implementing an agents of change program to target EHHMS compliance is feasible, but sustained improvement is less certain.