Has the use of a digital hand hygiene monitoring tool been associated with a decreased prevalence of hospital acquired infections in Siem Reap Provincial Referral Hospital?

Abstract

The practice of hand hygiene (HH) is a key intervention to decrease the rate of healthcare associated infections (HCAI). We performed a pre-post analysis to assess the association between the use of a digital monitoring tool for hand hygiene compliance and the prevalence of HCAI in the Siem Reap Provincial Referral hospital in Cambodia. The study analyzed 10 wards during the period of 2022-2024 and utilized a generalized linear model for our statistical analysis. Our study showed a non-statistically significant decrease in HCAI prevalence in the first year of our intervention (OR: 0.83, 95%CI: 0.58-1.20) with a p-value of 0.50. This trend was reversed in 2024 (OR: 1.40 95%CI: 1.06-1.86) with a p-value of 0.02, which we believe to be caused by unmeasured confounding. HH compliance increased from 29% to 64% at the end of the study period. Each 10% increase in correct HH compliance was associated with a non-statistically significant increase of 0.06% in HCAI prevalence (95%CI: -0.10 to 0.22) and a p-value of 0.50. These results suggest that we need to consider methods to further improve the validity of both our HH and HCAI data to mitigate bias and misclassification in our current collection methods.