Collecting the data but missing the point: validity of hand hygiene audit data

Area of Science:

• Healthcare quality improvement
• Infection prevention and control
• Clinical auditing

Background:

• Direct observation is a common method for monitoring hand hygiene compliance (HHC) in healthcare settings.
• The validity of routinely collected HHC data is often not rigorously assessed.
• Ensuring accurate HHC data is crucial for effective infection control.

Purpose of the Study:

• To critically evaluate the process and validity of hand hygiene compliance (HHC) data collection and reporting.
• To identify potential sources of error and bias in observational HHC monitoring.
• To assess the reliability of HHC data used for infection control assurance.

Main Methods:

• Analysis of five years of routinely collected hand hygiene compliance (HHC) data from a large hospital trust.
• Review of the HHC data collection process through auditor surveys and interviews.
• Comparison of organizational HHC data with data collected for separate research initiatives.

Main Results:

• Reported hand hygiene compliance (HHC) remained stagnant near the target after an initial rise.
• Variations in local interpretations of data collection protocols compromised data validity.
• Formal training in observation and feedback was limited among data collectors.

Conclusions:

• The validity of hand hygiene compliance (HHC) data is threatened by ambiguous definitions and inconsistent methods.
• Standardized, supervised, and regularly monitored data collection is essential for reliable HHC monitoring.
• Shifting focus from achieving targets to continuous performance improvement may enhance infection control outcomes.