Considering Hand Hygiene Observation Apps? Read Our Usability Findings First

Healthcare providers are well aware of the importance of hand hygiene to prevent infections, but hand hygiene compliance (HHC) rates among clinicians are often low. Facility-wide HHC monitoring is important to identify care areas, units, or departments that have low HHC rates so that targeted interventions can be implemented, HHC rate changes over time can be assessed, and staff feedback can be administered.

Methods for assessing HHC rates typically involve direct observation, in which a staff member observes and records clinician behavior. To minimize the chance that staff will change their behavior when they know they are being observed—a phenomenon known as the Hawthorne effect (Landsberger 1958)—a "secret shopper" approach is often used. With this approach, a clinician is assigned to discreetly observe and record staff HHC, unbeknownst to coworkers. Observers then record their findings, traditionally on a paper chart.

One limitation of this approach is that staff members may begin to recognize the dedicated hand hygiene observers, and thus may know when they are being observed. Thus, it may be necessary to rotate hand hygiene observers among several units or to...