Evaluation: The Joint Commission Center for Transforming Healthcare Hand Hygiene Mobile Observations App and Hand Hygiene Targeted Solutions Tool Web Portal

March 28, 2019 | Evaluations & Guidance


  1. The Hand Hygiene Mobile Observations app facilitates direct observation of clinical staff hand hygiene compliance and potential barriers to such compliance within a facility accredited by TJC. a) Hand hygiene compliance rates are calculated by dividing the number of hand hygiene events (i.e., washing hands with soap and water or rubbing hands with alcohol sanitizer) by the number of hand hygiene opportunities. To identify hand hygiene opportunities, the app considers the hand hygiene indications (i.e., reasons for hand hygiene, such as patient-room entry or exit) recorded in the app by the observer. The app considers each indication to be one opportunity. b) App users (i.e., trained hand hygiene observers or coaches) select a unit, data collector name, observer role, date, time, clinician role, clinician rounds, hand hygiene event (by answering "Yes" or "No" to the question "Did the person wash?"), and one indication (entry or exit). If the observer selected "No" for the hand hygiene event, they can select one or more potential hand hygiene barriers (e.g., dispenser location, hands full meds, improper use of gloves). Users submit observation data; the app cannot submit data automatically. The data is then sent to TJC Center for Transforming Healthcare servers for access by the Hand Hygiene TST web portal. c) Users of the Hand Hygiene TST web portal can do the following: (1) Review project parameters recommended by TJC Center for Transforming Healthcare. Users then choose to follow the recommended project parameters or not. (2) Choose one or more healthcare-associated infections (HAIs) (e.g., C. diff infections per 10,000 patient-days, methicillin-resistant Staphylococcus aureus MRSA infections per 1,000 patient-days) to monitor during a hand hygiene project. Alternatively, users can choose no HAI outcome metric. (3) Add administrators, observers, and coaches to projects (4) Choose the data-collection phase of the project: Baseline, Improve, or Sustain (5) Access observer and coach training materials, including a "Hand Hygiene Observer and Just-in-Time Coaching Education" video, a training module, a written exam, and scripts for coaches to use during observations (6) Access Hand Hygiene TST tutorials and help (7) Review, enter, or modify observation and HAI data (8) Export observation and HAI data as XLS files (9) Generate customized charts of: (a) Hand hygiene compliance rates by one or all clinician roles, hand hygiene opportunities, location (e.g., unit, department, or facility), and staff shift (e.g., 7 a.m. to 7 p.m.) per day, week, month, or year (b) Monitored HAI rates per month (c) Hand hygiene barriers by factor type (observable, nonobservable, or both), hand hygiene opportunities, and staff shift (e.g., 7 a.m. to 7 p.m.) per day, week, month, or year. Hand hygiene barriers (referred to by the app and web portal as "contributing factors") are ranked by frequency, and solutions are proposed that can help users focus their hand hygiene improvement efforts on the main reasons that a facility location is not compliant.

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