New Technology Helping Nurses Remember to Wash Hands

RICHMOND - Wash those hands!

Registered nurse Rhonda Williamson likes to think she cleans her hands with sanitizer every time she interacts with a patient.

But in case she forgets, a monitor dangling from her neck reminds her.

Williamson and other nurses on the 11th floor of VCU Medical Center’s Main Hospital are testing a credit card-sized wireless monitor worn like a badge that emits an audible alert if they enter a patient’s room without cleaning their hands. It uses Breathalyzer-type technology to detect the presence of alcohol, the main ingredient in hand sanitizers.

“If you look at health-care-associated infections, it’s thought that the majority of them occur because people are not washing their hands appropriately in health-care settings,“ said Dr. Mike Edmond, chief hospital epidemiologist at VCU Medical Center.

Nationally, the Centers for Disease Control and Prevention estimates that 1.7 million to 2 million people pick up infections during a hospital stay every year, and an estimated 99,000 die from those infections.

The costs of such infections can be staggering—with one 2009 economic analysis suggesting that such ailments cost $28.4 billion to $45 billion in direct treatment costs annually.

Health-care accrediting agencies such as The Joint Commission consider adherence to federally recommended hand-hygiene policies when evaluating hospital infection-control practices. Public-health officials emphasize the importance of hand-washing to curb the spread of infection such as influenza in all settings.

The wireless monitor, in prototype stages, is being developed by BioVigil LLC, a Santa Rosa, Calif., research and development firm with 10 employees. It is being tested in a two-week trial at the VCU hospital in downtown Richmond.

Nurses on the 21-bed unit wear the monitors, and there are containers of hand sanitizer and gloves outside of patient rooms.

When a nurse walks into a patient’s room, a wall-mounted sensor sends a signal to the badge to check for the presence of alcohol.

The nurse places her hands near the badge, which takes a reading. A green light indicates the presence of alcohol. A red light indicates that no alcohol and the need to cleanse hands.

“All the information from that badge is wirelessly transmitted to a central station where you could watch everybody’s hand-hygiene compliance in real time by person,“ Edmond said.

VCU staff members monitored hand-hygiene compliance on the unit for four weeks before starting the trial. Those results show that workers cleaned their hands 67 percent of the time.

Edmond said early results show that in just a few days, hand-hygiene compliance was up 90 percent or better and as high as 100 percent for some nurses.

BioVigil envisions a market much larger than hospitals.

“We are also talking to a couple of major food chains, because we see the application pretty strongly in fast-food service,“ company president Brian Sheahan said in a phone interview. “We also see the application in convalescent homes.“

Company officials declined to say what such a system might cost.

Most hospitals have some system now to monitor hand-hygiene compliance. VCU, for instance, rotates a person through units who visually checks to see if people are cleaning their hands.

At Bon Secours Richmond Health System’s hospitals, alcohol-based sanitizers are in every patient room and throughout facilities for visitors and staff, said Megan Walworth, community relations manager. Education is ongoing and occurs in a variety of settings, such as training and routine staff meetings. There also is visual monitoring of compliance.

The Virginia Department of Health was recently awarded a federal grant of just more than $1 million to reduce health-care-associated infections. That money will be used for training and for enhancing a system in place since 2008 that requires hospitals to report a certain type of health-care-associated infection to a federal database.

A legislator who developed a serious infection during a hospital stay introduced the bill.