Increasing Hand Hygiene Data Accuracy and Reducing Bias Through Standardized Education

Background Hand hygiene (HH) is the number one intervention to prevent hospital-associated infections. Accurate HH data is challenging to collect for multiple reasons including biased data collection, inconsistent training, and the Hawthorne effect. Inaccurate HH data makes it difficult for the Infection Preventionist to enact meaningful change for the facility to increase HH compliance. In a Level I Trauma Center, secret shoppers did not receive standardized HH data collection education and were frequently trained by the trainer. The objective of this study was to evaluate HH compliance before and after standardized education. Methods A pre-post study was utilized in a Level I Trauma Center to evaluate reported HH compliance before and after standardized education of secret shoppers. Infection Prevention trained a leader and at least one HH champion from each unit or ancillary service between March and May 2019. Any champion who continued to report high HH compliance were shadowed to determine the cause of their over-reporting to reduce bias in reporting. The 5 months of HH compliance pre- and post- intervention were compared utilizing a t-test. Results A total of 91 HH champions from 41 departments attended the standardized education. The average HH compliance was 97.5% (n = 1212) in the pre-intervention period compared to 75.9% (n = 2575) in the post-intervention period (p Conclusions Standardized education and bias follow-up significantly reduced over reporting of HH compliance. By moving to a standardized education model, Infection Preventionists collected more accurate HH data to better understand opportunities in their facility. With access to more accurate data, Infection Prevention will start to assess gaps in HH practices to improve compliance.