How hand hygiene technology can be the game changer in the next public health threat

An article published in the February issue of Medicoteknik magazine on The Modern Hospital featured Sani Nudge and was published originally in Danish in February 2021. The English version is available below. 

View the article in Danish

Co-authored by Sani Nudge Medical Director Dr. Marco Bo Hansen and Head of Marketing Nancy Carleton

Antimicrobial resistance is the biggest threat to our health. The solution to combat this lies in technology and hand hygiene prioritization being the cornerstone of our public health threat response.

Antimicrobial resistance in society

With immense “super hospitals” centralizing  how municipalities manage healthcare; infection prevention and hygiene management will remain at the forefront of public discussion. The threat of future outbreaks, beyond the 2020-born fear of Covid19 continues to linger. Future threats are led by the advent of the antibiotic era, in which antimicrobial resistance is declared by the World Health Organization (WHO) as one of the top 10 global public health threats facing humanity. 

According to the Novo Nordisk Foundation “700,000 people die each year from infections resistant to most or all antibiotics, and the number is increasing by the day. Antimicrobial resistance is projected to kill more people than cancer does by 2050, which would reduce global economic output by between 2% and 3.5% and severely cripple modern medical and surgical advances.”

Over the last year, we have learned how to prioritize infection prevention practices, while being mindful of the greater good of our society during the coronavirus emergency. We listened to the experts as they discussed risk assessment and recommendations. We used alcohol gel to sanitize our hands often and with more diligence than before. We wore masks, stockpiled cleaning supplies, and generally kept the recommended distance from our neighbors on the train and in the store. While our independent efforts are largely credited with best practices for handling the virus containment, the biggest area of opportunity and concern is in our healthcare facilities. 

In the United States, a national initiative is underway in this development as seen here in the article CDC launches a new plan to tackle antibiotic resistant infections. It is time that the rest of the world take the same level of prioritization and planning to prepare for this threat.

Encouraging a healthier healthcare environment

According to a study published by the Centers for Disease Control (CDC), improved hand hygiene compliance by 10% in a healthcare setting reduces the rate of infections by 6%. Hospitals, where our most vulnerable community members are, can see reduced infections with hand hygiene measuring investments. The study found that a “pursuit of excellence for hand hygiene compliance led to substantial HAI reductions hospital wide.” 

Additionally, a study out of China, following the outbreak of Covid19, found that “comprehensive monitoring of hospital environmental hygiene during a pandemic outbreak is conducive to the refinement of hospital infection control.” However, the monitoring of hospital hygiene is often a manual process which is time consuming, laborious and expensive in terms of manpower. This becomes an even bigger problem during the corona pandemic where healthcare is squeezed on resources.

This is why automated monitoring technologies that encourage hygienic practices are dominating the solutions for preparing for future public health threats. According to the Danish study published in BMC Emergency Med, 1 in 5 patients admitted to Danish Emergency rooms are carriers of multiresistant bacteria. This potential spreading environment already creates an environment for concern. Larger facilities that host more people and community resources, such as Super Hospitals are an even more major player in the discussion.

The healthcare industry tends to have a more conservative approach to adopting technology. Doctors are used to large randomized trials but sometimes that is as effective as “using a sledgehammer to crack a nut” thus  delaying important technology conquests which patients and healthcare workers can benefit from. The industry has noticed that things are slowly changing. The coronavirus pandemic has sped up the process of countries’ adoption of technology worldwide.  Denmark and Scandinavia are said to be early adopters of technology in Europe, compared to their European counterparts, which is more reason for them to lead the charge of technological adoption. 

Introducing technology that prepares and impacts the threat of an outbreak

Sani Nudge, a Danish solution emerged in 2015 as a connected monitoring system that uses IoT sensors to encourage and improve hand hygiene. With the product influenced by behavioral theory, the system records information, similar to how a Garmin watch measures and reports heart rate, fitness levels, and such. Sani Nudge focuses on measuring the hand hygiene behavior and patient contact of healthcare professionals in a hospital. 

The system was built to measure according to the 5 moments of hand hygiene, the WHO recommendations for increasing proper hygiene practices in healthcare.  As an auxiliary tool, it can use dynamic light-based nudges to influence behaviour such as reminders to wash hands or sanitize. The technology then anonymously reports its findings to an interactive analytics online tool known as Sani Analytics that allows healthcare professionals to know their compliance levels, their team’s improvements, and understand their patient contact scenarios. 

The solution and increased hand hygiene efforts go hand-in-hand (no pun intended) and has been attributed to accomplish such achievements as: 

• Improved hand hygiene for healthcare workers in a hospital. Users have shared that they have a constant and better overview of their personal and team hand hygiene performance when using automated devices as a tool.
• Reduced short term sickness: hand hygiene is known to produce a safer and healthier team due to increased hygienic behaviours.
• Increase patient and staff safety and protection. When the staff is healthier, the patients they serve are at less risk of common healthcare associated cross contaminations and infection spreading.
• The solution is known to influence lasting behavioural change in hygiene efforts.
• The solution is user friendly to use and implement, which means less burdensome staff resources being used in direct observation.
• Healthcare associated infection (HAI) rates are effectively lowered.
• The system measures and documents effects of implemented improvement areas, building upon proven and trusted results.
• It provides transparent data which is safe and reliable to back up improvement work.
• There is long term cost savings associated with this solution including:
  • Improved resource allocation.  
• Optimises staff workflow.
• Bring down the queue for elective operations.

Technology that can effectively contact trace in situations that warrant it

Additionally, the tool has been used as a part of a study with Aarhus University Hospital, Sølund nursing home, and the Technical University of Denmark in a project, COVIDtrace, which is in development and being tested as a digital tool to improve infection detection and hand hygiene among healthcare professionals in hospitals and nursing homes. The solution will help fight the spread of corona in both the primary and secondary sector. 

On COVIDtrace prominent member of the healthcare industry Else Smith, former WHO Board member and Sani Nudge Clinical Advisory member said this: “My many years of experience have taught me that data is key in driving behavioural changes. Moreover, the COVID-19 pandemic has underlined that good surveillance is crucial for us to initiate relevant strategic initiatives”.

All in all by increasing hand hygiene prioritization, infections are reduced. Sani Nudge, is a leader in Europe for this type of innovation being used in hospitals in 5 countries and across different types of organizations in the healthcare community. While the threat of future outbreaks, antimicrobial resistance, and more risks to our public health may seem bleak, the technology is there that can combat these threats and increase the health and wellness of those that we love.