A New Performance Metric to Estimate the Risk of Exposure to Infection in a Health Care Setting: Descriptive Study

Area of Science:

• Healthcare-associated infection (HAI) research
• Infection control and prevention
• Clinical informatics

Background:

• Health care-acquired infections (HAIs) remain a significant challenge despite monitoring efforts.
• Current hand hygiene (HH) performance metrics do not fully leverage data from electronic monitoring systems.

Purpose of the Study:

• To introduce a novel parameter for quantifying individual patient HAI exposure risk.
• To incorporate temporal and spatial data of healthcare worker HH adherence into risk assessment.

Main Methods:

• Patient exposure risk calculated using consecutive missed HH opportunities, room visit frequency, and time spent in/out of rooms without HH.
• Comparison of patient exposure risk with Entrance Compliance Rate (ECR).
• Analysis of data from an inpatient nursing unit over 12 weeks.

Main Results:

• No strong linear correlation (r=0.7, P<.001) found between ECR and patient exposure risk.
• ECR does not always reflect actual patient infection risk; high ECR rooms can pose significant infection risk.
• Patient exposure risk effectively incorporates factors crucial for quantifying infection risk.

Conclusions:

• Patient exposure risk provides a more reliable estimation of HAI risk than ECR.
• The novel parameter accounts for temporal and spatial dimensions of HH adherence for improved accuracy.