A Free Mobile Application Improves the Efficiency of Hand Hygiene Observation Collection: Experiences at a Pediatric Hospital in South Texas

Hand hygiene (HH) is the most important means of reducing hospital-acquired infections. However, compliance at health care facilities remains deficient. A process improvement study was conducted at a 191-bed, pediatric hospital in South Texas evaluating a free mobile application for HH surveillance, compared to traditional pen-and-paper methods. Using a series of Plan-Do-Study-Act (PDSA) cycles, the application was piloted on a small scale and then trialed facilitywide from June to November 2021. The number of HH audits was compared to the preceding period using percentage change analysis. The mobile application resulted in 7,388 HH observations collected, compared with 3,082 previously, representing a 140% increase. Two staff roles in the process (data entry and analysis) were eliminated, as observations were pushed directly to the infection preventionist, eliminating approximately eight hours of staff time monthly. The application enabled almost real-time updates to the HH surveillance dashboard and improved the detailedness of the data as more variables were collected during each HH observation. This is a practical alternative for innovating HH observation compared with more sophisticated and expensive HH surveillance technology.