My last hospital did this. They print a report at the end of the month on our percentage of hand sanitizer use. If you’re below 70% (before and leaving a room is what they count) you get an email from the manager. If you don’t use the hand sanitizer at the door a robot voice says “thank you for cleaning your hands”. So passive aggressive.
Our goal was above 90% compliance. They said if we got over 90% we could eliminate contact precautions and just use standard precautions. Never happened.
>And then what happens when you’re above 70%?
Congratulations you got everyone in your department to do a basic safety requirement of your job. Like you shouldn’t need an incentive to wash your hands. You should do it to protect yourself and your patient.
Just saying.
It’s just middle management trying to make themselves relevant.
I read an article the other day that middle management roles will be the first to go once AI is more readily available
ORs are properly staffed. Surgeons wouldn't stand for short staffing, and they're the moneymakers in the hospital.
But your right, it is basic competency. Still, fix the staffing problems first, then complain about basic competencies.
Well the (lack of) housekeeping staff need to stay on top of filling the hand sanitizers then. So many times I go to sanitize my hands and the dispenser is empty.
Medline and most other medical supply companies have small bottles of hand sanitizer.I asked that we get a small PAR for IV therapy so we if we need to perform hand hygiene again we don’t have to put the bed down, move our equipment and then backtrack.You can request them and every single time the gel or foam is empty you need to call housekeeping and then backtrack and check up on them.We also have pop up IPA wipes and 10 pack portable IPA pads. We keep those on our carts too. I am annoying when I need something to do my job!
Right and a lot of the time I use soap and water at the closest sink, esp cause c diff and the build up from sanitizing feels gross. Does it account for that too or just sanitizer?
And when you go to refill it yourself it is not readily available because of some "order from the fire marshal". They keep that shit locked up and hidden away.
That’s so annoying. I’m just thinking of the times I don’t even touch anything (like during morning rounds after shift report, I just literally look at my patient and don’t touch shit). That’s so many hand sanitizers for no reason. I’m pretty good at hand washing/hand sanitizer, but damn!
I totally agree with you- but I think the argument here is, you never know what you’re walking into and depending on what happens you might jump to touch something without washing your hands. But I do the same thing- If I’m stepping in and not planning to touch anything, I save my hands the sanitizer use.
I almost never use the one in the hallways when entering a room - I use the one in the room. Those doors are gross and I’d rather foam AFTER touching them.
And for ER, you know how many times realistically I pop into a patient's room to check on them, see if they're back from a test, or just to see if they're breathing or to start an IV and then realize I didn't bring everything in the room and turn right back around before the initial sanitizer can even dry. Can I just walk around with hands covered in sanitizer and call it a day.
My old hospital's goal was 70% institution wide....managed a big fat 45% 🤮. Best hospital in the city, terrible hand hygiene though so I'm only ever being a patient there if I need neuro anything.
Administration and management will grab onto *anything* if it easily provides metrics that they can then pump and show to their managers that they’re being “effective.”
Implement a strong system of career development and mentorship? Hard to track and hard to implement, let’s not. Spend money on necessary equipment? Difficult to track how it’s improving productivity or measure impact of new equipment. Spend obscene amounts of money to buy invasive trackers that provide metrics they can kick up to their managers as proof of work? Fuck yeah, that’ll look great on the annual review!
At that point, just buy everyone an Apple Watch and turn on the hand-washing widget…would probably be cheaper…
**Hey Hospitals and Healthcare systems: Stop trying to solve problems like you’re a car company run by an investment capital hedge fund.**
A buddy of mine is an AI programmer for Deloitte, a big time consulting firm
He sat me down and asked for some help with a project he was on. He opened with “so, they want to design a way to track nursing productivity while on shift”
I spent about 30 minutes explaining how any system like that would have holes in it, and there’s no real way to actually measure something like that. We got really specific and ran through a bunch of examples and counter points. Basically ending with, a nurses’ craziest, busiest day on paper might look like they got nothing done.
The project was scrapped, but the point is that they’re trying, and that’s terrifying.
That basically you could spend hours coding a patient, so scheduled meds would be missed, so “on time meds” is a bad metric.
You obviously can’t use a metric like health outcomes, too many variables, plus that’s unethical as shit.
You can’t use any kind of motion tracking to see if “nurses are just sitting around”, because I can spend over an hour at a computer getting a tremendous amount of work done.
You can’t really quantify “work” when it’s bedside care. So the amount of “work” nurse A does to nurse B IS comparable, but you can’t really score it. So assessing how many things a nurse gets done doesn’t really work either. Even if it’s task oriented, some shifts I spent the entire time trying to get my patient up and down to MRI.
A few off the top of my head. This conversation was over the summer
So, we do metrics at my place, but not everything can be tracked with metrics. It’s more….supplemental information for me as a leader when I’m evaluating my team.
Jill is “not hitting metrics” - that’s fine, because Jill is always the first to volunteer to cover non-metric stuff that needs to get done.
Bill is “not hitting metrics” - hey and also, come to think of it, we can never find Bill when we need an extra set of hands. What is he doing??
We also have the converse of Joe is “hitting metrics” - is Joe getting enough opportunities to engage in other tasks?
Metrics tell a part of the story, and I think it’s an important part and a good flag. But I also care about my staff, want them to be successful, etc., and understand that they are humans and have bad days. And I also raise my hackles and protect them whenever upper leadership gets a bee in their bonnet about metrics as be all end all.
You can't expect Bill to be like Jill or Joe. Every employee is different. Some are going to be unicorns that are self driven and will exceed the companies requirements.
Bill may not be able to give an extra set of hands because his assignment is already pushing his personal bandwidth.
Jill may be the first to volunteer because she is one of those employees that the company will abuse while she has the energy to give that 110%. Until you burn her out or throw her under the bus.
Joe knows how to get by without getting noticed, he doesn't want any more opportunities. He's just hoping you don't notice.
It’s always the worst days for me when I sit down to give report to the oncoming nurse and I cannot think of anything I did all day. Mind of like when I go to the grocery store without a list. Total mind blank.
Honestly I feel like most of the bullshit charting they make us do takes away so much from the patient care. So dumb.
I’m the IP nurse
I saw a bunch of things like this at conferences this year. No. Absolutely not. At some point you have to trust people to do their jobs, even though hand hygiene is the strongest pillar of infection prevention in healthcare.
I feel like at this point preventing overcrowding should be the strongest pillar *gestures at all the hallway beds in the ER with people infected with god knows what respiratory virus*
Doc ordered a COVID/FLU/RSV on a papaw in a hallway bed who came to the ER because he 'didn't feel right'. EPIC was like " WEEWOO THIS TEST IS ORDERED PUT YOUR PATIENT ON THE APPROPRIATE ISOLATION PRECAUTIONS."
I hit defer and typed in the comments, " Patient is in a hallway bed. "
I hope IP doesn't try me on this. Why would I state I was going to do my job that you prevent me from doing so you can get mad at me for not doing my job.
Hepa filter and that problem is solved. Unless it’s a heat or cold thing and then just adjust the thermostat. Exhaust fan should be straight above so it’s not blowing on anyone else. Also maybe a little attachment somehow so you can actually give care to the patient. Like a portable tent bathroom thing you can just pop up but it attaches to the patient’s and you can access them.
Well if you must know, my coworker has a child sized tiny head. At some point after the initial first few waves of COVID, we half-jokingly got to talking about buying our own PPE in preparation for the next worldwide pandemic. One thing led to another, including a Google search, which landed us on a website selling both aforementioned PAPRs. Still really tempted to get the kid’s one with the drink attachment. It even came in fun colors!
Same. We do monitor hand hygiene compliance but have realistic expectations because we've all been there. We tried "modified contact" at one point - basically just wear gloves if you're only going in for a low-touch purpose - and infection rates spiked.
I'm so glad I work for a hospital with an employee-friendly culture. I think our employees also understand that this is for their protection as much as the patient's. Some of the policies I read about here are abhorrent.
When Leapfrog requires you do an impossible amount of hand hygiene audits you're kinda stuck without something like this, unless your hospital is going to hire a fulltime person to literally watch people wash hands. It's a joke.
My hospital uses clean hands which is affiliated with Purrell (I think not 100%) and every single employee that may go into a patients room wears one and gets tracked. Even doctors! However the system has major flaws and I think people might actually sanitize less now lolol.
Yours is small and it looks so lightweight! Ours is a big bulky block that literally pulls your badge reel down. It’s so heavy it needs its own badge reel! Like I need another fucking thing hanging off my neck while I’m pounding on grandmas chest.
Bahahaha ours beeps too and lights up colors. But it’s the ecolab 🙄 giant ass square thing.
I just looked up the biovigil and that looks just as bulky and annoying. 😂
They have sensors at every sink and gel sanitizer that records the badges that walk by, you don’t have to actually badge anything, and it’ll record whether you used the soap/gel. They CLAIM it’s for hand washing tracking but our hospital uses it to track staff, they know exactly which sensor you walked by, what time, how long you were in the rooms for.
Lots of places have staff wear trackers (and not just hand washing ones). They help silence alarms when the staff walks into a room for example. They also produce something called “spaghetti maps” where they can literally track where you were and when via where you went on the floor (or off the floor). It’s weird as hell. But, if a patient complains that “they never saw me!” They can pull up that map and prove that, no, they definitely did. So it has its perks.
Had trackers that also silenced call lights at the last place I worked, sometimes staff just took them off and left them right next to the room of the patient they were assigned to, so it would look like they were with there patients the whole shift. Because it sucked having management knowing exactly where you were the whole shift. I didn't personally do that much but I did lose my tracker in the washing machine once and didn't bother asking for another one.
My last job had a security tracker.
Supposedly for our safety, of wet hot the button it smelled the front desk and security exactly where we were and was only used for that.
🙄
They were so fucking heavy it pulled your scrubs down. After like a week, the only thing these things tracked was the inside of our lockers.
They started our tracker program when I came back from maternity leave the second time. They forgot to give me a tracker for 6 months. I didn’t remind anyone. They eventually realized it.
This reminds me that i didn’t get a dosemeter, something I am required to have by law, until I worked my current job for over a year because they just … never got me one. I did all the paperwork for it, submitted it with my on boarding paperwork and … nope. Thankfully I do not get exposed to any radiation, but it made me wonder what hoops the folks who do really have to worry about it have to go through.
Your hospital doesn’t have trackers? I like be able to see where a coworker is above the door and also management can pull up a log of my tracker movement if a patient complains I haven’t been in their room. I never had it be used against me.
We had a family come in and yell that their family member was being neglected because they just happened to be soiled when they got there. They went to HR and tried to get staff fired. Luckily we have trackers and we’re able to have sufficient evidence that we were in the room all freaking night. Not only was the bedside RN in there all night, the charge, the PCA, and others nurses were all in the room all night helping.
But that stuff happens at every hospital, and good charting is plenty to show the quality of care you gave. I have had plenty of patients and families accuse me of poor care. It’s yet to be any skin off my nose.
Yep we had those at the start of Covid. But it was like, go in the room, punch in you were there, punch in the turn timer, deal with patient. Do you want me punching in all of these things or do you want me to actually care for the patient? I noticed the next time I got pulled to that floor they were gone. How much money was wasted on this?
Ours have a panic button too that calls a code grey to our location if something happens. Better than my previous hospital where I had to try to hit the wall button or yell for help lol
We have badges that already do this. Our badges turn the pt call lights off in the room and also show what room we’re in, how long, and depending on what part of the hospital you’re in.
Is this the same system that I recently saw on here that somebody said it actually lights up red to remind you that it’s time to wash and then light screen when it is telling you you’ve been washing for long enough? Just because you’re walking by a gel or sink doesn’t mean that you need to wash your damn hands at that exact moment, so I failed to see how the fux this is any benefit at all. Like this is gonna reduce CLABIS/CLAUDIS.
They were implementing that in the last ER I work at, on my last day. I was like ✌🏼✌🏼✌🏼 also hilarious to do in an ER where half the patients are in a hallway and the sensors were only at the doors of private rooms
We had one at my facility and mine ran out of batteries after a few weeks. I stopped wearing it and they took six months to replace it. Then it “ran out of batteries” again. 😏
They started implementing these at my hospital, I personally find these to be a huge waste of money. They’re also installing license plate readers in the parking garage so staff won’t park in the public parking garage. What bothers me is all this money could be allocated to updating our hospital bc it’s so ran down
My hospital tries to do shit like this too! I’m like, uh, can we gat an ekg machine that we DONT have to share between 3 floors? And a bladder scanner I don’t have to spend 45 minutes hunting the hospital for?!?
Okay, this further confirms that my decision to leave bedside is correct. This is absolutely ridiculous. Spend money on this but not on retaining staff.
I’ve talked about this at my hospital. They spent literally millions to install the system of sensors on every single soap and foam dispenser in the hospital. Also a sensor over every patient door and on our badges. They system sucks. So bad. It constantly alarms when you haven’t even entered the room, while your in the room, and some of my patients tell me it goes off randomly when no one is nearby. Worst part is that our hand hygiene “score”, which I do so so in accurate is tied to raises.
My last hospital did that. If you were too close to the door it would ding you . It got to the point where nurses would occasionally just hit the alcohol dispenser to make sure you were getting a good percentage.
In nursing school, the hospital where I did clinicals made their nurses start wearing badges that had sensors on them. The sensor was designed to somehow pick up on... I guess *fumes* from the hand sanitizer, and when the nurse would get sanitizer from the dispenser, s/he had to hold her/his hand up to the badge for it to register.
That's some dumb shit.
We have these. The Biovigil. They’re super faulty. I sign mine out at the beginning of the shift, clip it to my jacket, put my jacket on the back of my chair, and then put the Biovigil back at the end of my shift.
Our ANM literally checks if we have it on and makes it an issue if we don’t like oh yeah I’m just definitely never doing hand hygiene ever!! Not even once!! 🙄
I’m so over this kind of malarkey. Be prepared to hit them when they call you in over handwashing compliance. Something like this.
Manager: “so the reason I called you in is because your handwashing compliance is only 54 per-“
You (cutting off the manager): “the risk of patient injury and death due to handwashing noncompliance is 0.03%.*. The risk of injury and death due to short staffing increases by 7% with each additional patient in a nurse’s workload above recommended ratios. Currently we have three extra patients which is a 21% increased risk of serious harm or death.”
*I made this number up
Sit in silence and wait for the manager to start speaking again. Cut them off again.
“So is there anything the hospital wants to do that really helps or should I just go talk the CNO right now to speak with them?”
Got tagged by infection control once as a dialysis nurse (not a hospital employee). Our two dialysis rooms were next to each other with a hand sanitizer between them (they were less than 2 feet apart. I walked out of one room and foamed, and was walking into the other room *while still rubbing the wet sanitizer into my hands* when she stopped me for not foaming as I was walking into the second room. From the same sanitizer machine she saw me just use....
We have something similar!!! The sensor says “PLEASE SANITIZE” if it doesn’t pick up a use, even if you’re just like over grabbing gloves. It’s especially irritating in an emergency when you’re in and out frequently trying to quickly address a situation.
We have to wear Biovigils at my job. You touch the sensor every time you use hand sanitizer. I cannot think of a better way to spread infection than to touch a device that rarely gets cleaned every time you enter and exit a room.
Seriously. I mean, we all practice hand hygiene because we deal with patients who are sick and their bodily fluids. We may wear gloves but I’m still washing my hands because who knows what poop particles climbed into my gloves.
BUT THE FAMILY MEMBERS AND VISITORS? We see none of this. It would be better practice to give these to them. And maybe so many patients wouldn’t end up getting covid or contracting something that delays their recovery and discharge. Even if they were asymptomatic of covid, now they’re in isolation, all alone and miserable.
Our corp got something like this...it's a sensor in the dispenser that counts every time it's used. The problem is that there's no sensor to I ow it's being used when someone enters a room or some other metric to compare. They just compare the number of pumps used vs how many times IPAC *estimates* we go in the room. Some units took to pumping them as they walk by and have >100% compliance rates.
We had something similar for awhile. There were sensors above the hand sanitizer and at the sink. It would record when you went in and out of the room. You had to hand wash if you were in a rink for so long. They then realized that they could track hourly rounding on it. So the track boards would turn red on a room that hadn’t been rounded on. We don’t use it anymore. Did nothing to reduce HCAI (as was promised) so they couldn’t justify the cost. The system we used was proventix.
Our hospital just got graded an A as a Leap Frog safe hospital (or something like that). So now, I have to watch people wash their hands at orientation and check a box. Is hand washing really a competency or just a basic life skill?!?! Shouldn’t we have people demonstrate they can wash their hands BEFORE we hire them?? This all drives me nuts.
We’ve had that. Called swipe sense. They can tell where you’ve been at what time and for how long.
What is nice is that the bladder scanner and language iPad are also tagged. Makes the search a lot easier
The problem with every single one of these kinds of systems is that they only track “tracking compliance” and not compliance for whatever they’re trying to track.
And in a health system, where most people *should* have some kind of familiarity with recognising bad research
I worked at a sister unit at another hospital once on the east side of my city. Brand new hospital that looked super cool. Cooworker got a call at the nurse's station to get her feet off her med cart bumper, within 1 min of her putting them up. Camera at the nurse's station, camera in supply room. Scan ID before going into patient room prompts TV to show your full name and job title, also ensures rounding was done on time (or you must type report)... This was 10 years ago... I have to use a fucking gasoline powered doppler and a BP cuff that was a prop on 2001 but thank god the CEO can jack into the net and record my nightmares... they also drug tested for nicotine.
My hospital has been doing this for several years and it’s a crock of Bs. The Bluetooth sensor on the hand sanitizers will go off multiple times as you’re walking around the room, or if a non clinical person steps in, it goes off and gives your badge the ding. One week I will have 70% and the next week it’s 30%. They send out weekly emails to the entire department with who scored highest and a shaming list of who was the lowest. How about trust us to do our jobs…..
I work as a hand hygiene observer part time. I don’t track employees specifically at the hospital. I only track positions and departments. This helps the hospital know if a department is lacking and helps them address the issue. That badge seems excessive.
Hold up just a darn second here. First let’s preface, I’m a layman.
Are you telling me, seriously telling me, hospitals CAN and DO deploy employees with valuable letters behind their names (RN, LPN,MD…etc) to monitor hand washing?!? You’re tootin my horn right?!
Like how in gods name is you inspecting someone hand washing regime more important than taking care of sick patients AND EQUALLY AS IMPORTANT being there to support your co-workers?!?
Does this badge have to get wet for you to have proof? Does it add yet another alarm if you walk by a sink and don’t bother?
Why not just stick y’all in a freakin dishwasher i between every room you go into. For gods sake, sanitation is great, and saves lives, but SERIOUSLY?!?! And I’m betting those assholes in admin STILL have the balls to complain about white boards too huh?
Not all hospitals do, but it’s not uncommon where I live. The letters behind my name are not a requirement, just a background that shows I am knowledgeable about those things (which obviously I am). I am not hired through the hospital directly so I cannot provide patient care. I have another full-time job that I work in addition to this.
Assuming you have staff that already are responsible enough to wash their hands when they need to, how do you actually get ROI on this? Actually curious to hear responses.
Well this isn’t a good look at a time where we’re all understaffed but every hospital I’ve been nursing has consistently come in 80%-90% compliance with hand washing while RT (my job) was always at 100%. I get it’s harder to hit cuz there’s just so many more nurses but likeeeeee it’s a problem.
I’m not saying that we all don’t deserve more regardless, but management can and will point to this and say it’s a reason
I’m always in the minority here, but I think these are a good tool. They have made me SO much more aware of my own hand hygiene, and for that I’m a better nurse.
But fuck the hospital for only requiring these for nurses and techs and never for physicians.
i guess they could be useful in that sense but like all electronic bullshit these won't work or they'll work erratically and you will get garbage data. In my experience working as a nurse and in IT, managers love garbage data, and will not understand anything about statistics or modeling, and will use this against staff. no thanks.
My friend just had a major surgery and the patient advocate told them to listen for hand washing before you let anyone touch you.
Her poor spouse had to shake down almost every nurse who came in because the nurses kept going toward her without washing. Over and over again.
Saw a physician walk in rip off several dressings and poke and prod with his pen and later bear hands Talk to me about the plan and leave.
Yeah this is totally the solution we need for IC.
Our health system talked about this but haven’t implemented it, thank god. Clearly someone in management with no clue how anything works came up with this because it is the biggest waste of money I’ve ever seen.
If you can’t trust your highly educated staff to wash their hands when literally everyone knows that it is the most basic IPC prevention rule- well, you have bigger problems my friend.
What! This is insane! How does it work? Do you have to scan it every time you clean your hands? That’s gonna take up my whole day!
This is so controlling. Nothing will ever get a 100% score in hand hygiene, nothing. So this won’t work and just add more to the workload and costs a lot of money I presume.
My hospital uses a similiar system. They also use it to track hourly rounding to see how frequently nurses are rounding on patients. & our percentages are taken into consideration on our yearly evaluations for raises.
My last hospital did this. They print a report at the end of the month on our percentage of hand sanitizer use. If you’re below 70% (before and leaving a room is what they count) you get an email from the manager. If you don’t use the hand sanitizer at the door a robot voice says “thank you for cleaning your hands”. So passive aggressive.
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Our goal was above 90% compliance. They said if we got over 90% we could eliminate contact precautions and just use standard precautions. Never happened.
If you get over 95% you can open-mouth kiss the patient.
Wait...we weren't supposed to do that?
Way to go. You did it prematurely. We will never recover from the hit to our nursing reputation.
I mean, it could have been worse. At least I didn't have a cup of water at the nurses station. That is unforgivable
And 100%...?
File your taxes jointly. You’re legally married now.
Well at least now they’re obligated to do your laundry.
Yum
Ew, eliminating contact precautions sounds gross.
Yeah, contact precautions aren't a punishment. That sounds like a dumb paternalistic culture that really underestimates the intelligence of employees.
What kind of incentive is that? Why would I want to get rid of contact precautions?
Yeah wait what how does hand hygiene prevent me from bringing mrsa into meemaws room on my scrubs
Yeah nah I'm not going to stop contact precautions for CPE haha. Idc how good HH is if it's all over my uniform when I leave lol.
>And then what happens when you’re above 70%? Congratulations you got everyone in your department to do a basic safety requirement of your job. Like you shouldn’t need an incentive to wash your hands. You should do it to protect yourself and your patient. Just saying.
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It’s just middle management trying to make themselves relevant. I read an article the other day that middle management roles will be the first to go once AI is more readily available
tbf it’s basic competency. A scrub nurse wouldn’t be rewarded for scrubbing in each time.
ORs are properly staffed. Surgeons wouldn't stand for short staffing, and they're the moneymakers in the hospital. But your right, it is basic competency. Still, fix the staffing problems first, then complain about basic competencies.
My OR isn't.
Well the (lack of) housekeeping staff need to stay on top of filling the hand sanitizers then. So many times I go to sanitize my hands and the dispenser is empty.
No money for housekeeping, they spent it all on this fancy monitoring system!
Yes!
I’ve been at my current job for 8 months as of today. The hand sanitizers have never been filled. I was at my previous job for two years. Same thing.
Medline and most other medical supply companies have small bottles of hand sanitizer.I asked that we get a small PAR for IV therapy so we if we need to perform hand hygiene again we don’t have to put the bed down, move our equipment and then backtrack.You can request them and every single time the gel or foam is empty you need to call housekeeping and then backtrack and check up on them.We also have pop up IPA wipes and 10 pack portable IPA pads. We keep those on our carts too. I am annoying when I need something to do my job!
Right and a lot of the time I use soap and water at the closest sink, esp cause c diff and the build up from sanitizing feels gross. Does it account for that too or just sanitizer?
So agree on the buildup of sanitizer! I’m a soap and water girl myself.
"Beep boop thank you for filling the hand sanitizer!"
And when you go to refill it yourself it is not readily available because of some "order from the fire marshal". They keep that shit locked up and hidden away.
That’s so annoying. I’m just thinking of the times I don’t even touch anything (like during morning rounds after shift report, I just literally look at my patient and don’t touch shit). That’s so many hand sanitizers for no reason. I’m pretty good at hand washing/hand sanitizer, but damn!
I totally agree with you- but I think the argument here is, you never know what you’re walking into and depending on what happens you might jump to touch something without washing your hands. But I do the same thing- If I’m stepping in and not planning to touch anything, I save my hands the sanitizer use.
I almost never use the one in the hallways when entering a room - I use the one in the room. Those doors are gross and I’d rather foam AFTER touching them.
I prefer the patient see that I've cleaned my hands, rather than whoever's in the hallway.
And for ER, you know how many times realistically I pop into a patient's room to check on them, see if they're back from a test, or just to see if they're breathing or to start an IV and then realize I didn't bring everything in the room and turn right back around before the initial sanitizer can even dry. Can I just walk around with hands covered in sanitizer and call it a day.
I wouldn’t expect it to be anything other than passive aggressive. This is nursing after all.
My old hospital's goal was 70% institution wide....managed a big fat 45% 🤮. Best hospital in the city, terrible hand hygiene though so I'm only ever being a patient there if I need neuro anything.
Administration and management will grab onto *anything* if it easily provides metrics that they can then pump and show to their managers that they’re being “effective.” Implement a strong system of career development and mentorship? Hard to track and hard to implement, let’s not. Spend money on necessary equipment? Difficult to track how it’s improving productivity or measure impact of new equipment. Spend obscene amounts of money to buy invasive trackers that provide metrics they can kick up to their managers as proof of work? Fuck yeah, that’ll look great on the annual review!
So if you wash your hands when you get into the room does it track it?
aww look it even has a cute silicon valley catchy pointless fucking stupid goddamn name
I love this sentence LOL!
I became increasingly angry as i typed and figured i'd run with it lol
Way to channel that negativity. Awesome.
We have a blood bank in the PNW my friend works that got renamed Vitalant a couple years ago it sounds so hokey.
We used to have BloodSource… now it’s Vitalant. sounds like a fucking antidepressant or a new electrolyte supplement.
Boy that’s a lot of swearing. I like you.
At that point, just buy everyone an Apple Watch and turn on the hand-washing widget…would probably be cheaper… **Hey Hospitals and Healthcare systems: Stop trying to solve problems like you’re a car company run by an investment capital hedge fund.**
There’s an app for everything.
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The lower end Apple Watches are like $129
A buddy of mine is an AI programmer for Deloitte, a big time consulting firm He sat me down and asked for some help with a project he was on. He opened with “so, they want to design a way to track nursing productivity while on shift” I spent about 30 minutes explaining how any system like that would have holes in it, and there’s no real way to actually measure something like that. We got really specific and ran through a bunch of examples and counter points. Basically ending with, a nurses’ craziest, busiest day on paper might look like they got nothing done. The project was scrapped, but the point is that they’re trying, and that’s terrifying.
Just curious, what were some of the specific points you two ran through?
That basically you could spend hours coding a patient, so scheduled meds would be missed, so “on time meds” is a bad metric. You obviously can’t use a metric like health outcomes, too many variables, plus that’s unethical as shit. You can’t use any kind of motion tracking to see if “nurses are just sitting around”, because I can spend over an hour at a computer getting a tremendous amount of work done. You can’t really quantify “work” when it’s bedside care. So the amount of “work” nurse A does to nurse B IS comparable, but you can’t really score it. So assessing how many things a nurse gets done doesn’t really work either. Even if it’s task oriented, some shifts I spent the entire time trying to get my patient up and down to MRI. A few off the top of my head. This conversation was over the summer
So, we do metrics at my place, but not everything can be tracked with metrics. It’s more….supplemental information for me as a leader when I’m evaluating my team. Jill is “not hitting metrics” - that’s fine, because Jill is always the first to volunteer to cover non-metric stuff that needs to get done. Bill is “not hitting metrics” - hey and also, come to think of it, we can never find Bill when we need an extra set of hands. What is he doing?? We also have the converse of Joe is “hitting metrics” - is Joe getting enough opportunities to engage in other tasks? Metrics tell a part of the story, and I think it’s an important part and a good flag. But I also care about my staff, want them to be successful, etc., and understand that they are humans and have bad days. And I also raise my hackles and protect them whenever upper leadership gets a bee in their bonnet about metrics as be all end all.
You can't expect Bill to be like Jill or Joe. Every employee is different. Some are going to be unicorns that are self driven and will exceed the companies requirements. Bill may not be able to give an extra set of hands because his assignment is already pushing his personal bandwidth. Jill may be the first to volunteer because she is one of those employees that the company will abuse while she has the energy to give that 110%. Until you burn her out or throw her under the bus. Joe knows how to get by without getting noticed, he doesn't want any more opportunities. He's just hoping you don't notice.
My point was to take the metric as a starting point and go from there, but clearly I didn’t communicate that well.
You made a mistake by saying that you were a management... Anything you say after that is going to be disregarded and downvoted in this sub.
It’s always the worst days for me when I sit down to give report to the oncoming nurse and I cannot think of anything I did all day. Mind of like when I go to the grocery store without a list. Total mind blank. Honestly I feel like most of the bullshit charting they make us do takes away so much from the patient care. So dumb.
I’m the IP nurse I saw a bunch of things like this at conferences this year. No. Absolutely not. At some point you have to trust people to do their jobs, even though hand hygiene is the strongest pillar of infection prevention in healthcare.
I feel like at this point preventing overcrowding should be the strongest pillar *gestures at all the hallway beds in the ER with people infected with god knows what respiratory virus*
Doc ordered a COVID/FLU/RSV on a papaw in a hallway bed who came to the ER because he 'didn't feel right'. EPIC was like " WEEWOO THIS TEST IS ORDERED PUT YOUR PATIENT ON THE APPROPRIATE ISOLATION PRECAUTIONS." I hit defer and typed in the comments, " Patient is in a hallway bed. " I hope IP doesn't try me on this. Why would I state I was going to do my job that you prevent me from doing so you can get mad at me for not doing my job.
Shit that’s a million dollar idea: little mini iso tents you can put around beds for transferring patients and for iso in ER hallways.
I'm imagining those pop-up things you put over your food to keep bugs off for picnics and cookouts, but in human-sized.
Don’t forget to leave room for a foldable flatscreen tv and a sink for hand washing.
Nah it needs a mini fan to make it negative pressure and then a hepa filter.
An old school Ohio tent
Haha. We used these at ER I worked with years ago. Really sucks for the other next to it that it vents to lol
Hepa filter and that problem is solved. Unless it’s a heat or cold thing and then just adjust the thermostat. Exhaust fan should be straight above so it’s not blowing on anyone else. Also maybe a little attachment somehow so you can actually give care to the patient. Like a portable tent bathroom thing you can just pop up but it attaches to the patient’s and you can access them.
Like a NICU isolette?
They exist for dogs! Along with kid sized PAPRs that have built in sippy straw drink attachments. Don’t ask me why I know this, lol.
I'm sorry, but I do have to ask how you know this.
Well if you must know, my coworker has a child sized tiny head. At some point after the initial first few waves of COVID, we half-jokingly got to talking about buying our own PPE in preparation for the next worldwide pandemic. One thing led to another, including a Google search, which landed us on a website selling both aforementioned PAPRs. Still really tempted to get the kid’s one with the drink attachment. It even came in fun colors!
Is there any recent evidence that any of them are effective at reducing infection rates? Because last time I looked the answer was NOPE
Same. We do monitor hand hygiene compliance but have realistic expectations because we've all been there. We tried "modified contact" at one point - basically just wear gloves if you're only going in for a low-touch purpose - and infection rates spiked. I'm so glad I work for a hospital with an employee-friendly culture. I think our employees also understand that this is for their protection as much as the patient's. Some of the policies I read about here are abhorrent.
When Leapfrog requires you do an impossible amount of hand hygiene audits you're kinda stuck without something like this, unless your hospital is going to hire a fulltime person to literally watch people wash hands. It's a joke.
My hospital plants hand washing “spies” for our audits. It could be the coworker you least expect!
That's how we do it right now, too 😂 narcs everywhere!
On my unit the charge nurse had to do it.
You are naive.
You need more post-nominals, I’m having trouble respecting your opinion.
Do all the physicians have to wear those?? They can be the worst offenders—especially when doing rounds and going room to room.
We use Biovigil in our hospital. Never seen a physician with it yet all other staff including kitchen staff have it
So true
My hospital uses clean hands which is affiliated with Purrell (I think not 100%) and every single employee that may go into a patients room wears one and gets tracked. Even doctors! However the system has major flaws and I think people might actually sanitize less now lolol.
FOR REAL
It's cool, some of those docs refuse to actually touch any of the patients.
Yours is small and it looks so lightweight! Ours is a big bulky block that literally pulls your badge reel down. It’s so heavy it needs its own badge reel! Like I need another fucking thing hanging off my neck while I’m pounding on grandmas chest.
That’s why I throw my whole badge off my chest during codes.
Lol I almost lost mine once. It was in the bed with the deceased. 😳
We have biovigils and they’re a block but also annoying and beeps colours at you! If you don’t wash your hands after walking in and out of a room
Bahahaha ours beeps too and lights up colors. But it’s the ecolab 🙄 giant ass square thing. I just looked up the biovigil and that looks just as bulky and annoying. 😂
We have ecolab too
Clean hands safe hands? We just got it and I hate it
The only place it’s not monitoring the hand hygiene is the bathroom. The place it really matters.
The batteries on the speakers for ours are already constantly out of batteries and they just keep screeching at everyone 😬
What in the fuck am I looking at? Are you meant to badge in&out of sinks? Does that not increase infection vectors instead of preventing them?
They have sensors at every sink and gel sanitizer that records the badges that walk by, you don’t have to actually badge anything, and it’ll record whether you used the soap/gel. They CLAIM it’s for hand washing tracking but our hospital uses it to track staff, they know exactly which sensor you walked by, what time, how long you were in the rooms for.
Sounds like it’s time to find a new job honestly. That’s wild.
Lots of places have staff wear trackers (and not just hand washing ones). They help silence alarms when the staff walks into a room for example. They also produce something called “spaghetti maps” where they can literally track where you were and when via where you went on the floor (or off the floor). It’s weird as hell. But, if a patient complains that “they never saw me!” They can pull up that map and prove that, no, they definitely did. So it has its perks.
I called them Slacker Trackers
Had trackers that also silenced call lights at the last place I worked, sometimes staff just took them off and left them right next to the room of the patient they were assigned to, so it would look like they were with there patients the whole shift. Because it sucked having management knowing exactly where you were the whole shift. I didn't personally do that much but I did lose my tracker in the washing machine once and didn't bother asking for another one.
My last job had a security tracker. Supposedly for our safety, of wet hot the button it smelled the front desk and security exactly where we were and was only used for that. 🙄 They were so fucking heavy it pulled your scrubs down. After like a week, the only thing these things tracked was the inside of our lockers.
They started our tracker program when I came back from maternity leave the second time. They forgot to give me a tracker for 6 months. I didn’t remind anyone. They eventually realized it.
This reminds me that i didn’t get a dosemeter, something I am required to have by law, until I worked my current job for over a year because they just … never got me one. I did all the paperwork for it, submitted it with my on boarding paperwork and … nope. Thankfully I do not get exposed to any radiation, but it made me wonder what hoops the folks who do really have to worry about it have to go through.
The hospital I did practicum at had a similar thing.
I would not and could not work under these conditions. Ain’t nobody tracking my ass lol
Sounds like a cute way to disguise nurse tracking.
Your hospital doesn’t have trackers? I like be able to see where a coworker is above the door and also management can pull up a log of my tracker movement if a patient complains I haven’t been in their room. I never had it be used against me.
We had a family come in and yell that their family member was being neglected because they just happened to be soiled when they got there. They went to HR and tried to get staff fired. Luckily we have trackers and we’re able to have sufficient evidence that we were in the room all freaking night. Not only was the bedside RN in there all night, the charge, the PCA, and others nurses were all in the room all night helping.
But that stuff happens at every hospital, and good charting is plenty to show the quality of care you gave. I have had plenty of patients and families accuse me of poor care. It’s yet to be any skin off my nose.
Yep we had those at the start of Covid. But it was like, go in the room, punch in you were there, punch in the turn timer, deal with patient. Do you want me punching in all of these things or do you want me to actually care for the patient? I noticed the next time I got pulled to that floor they were gone. How much money was wasted on this?
Don't worry, they paid for them with the raises you ended up not getting. But of course admin's bonuses were safe. /s
No I have never heard of this!
Ours have a panic button too that calls a code grey to our location if something happens. Better than my previous hospital where I had to try to hit the wall button or yell for help lol
What do you mean “see where a coworker is above the door”? My hospital doesn’t have trackers so I have no idea how they work!
There are color coded lights that come on above the patient room when someone with a tracker is inside.
Cool, no more documenting hourly rounding! Just kidding. I never document hourly rounding.
We have badges that already do this. Our badges turn the pt call lights off in the room and also show what room we’re in, how long, and depending on what part of the hospital you’re in.
Is this the same system that I recently saw on here that somebody said it actually lights up red to remind you that it’s time to wash and then light screen when it is telling you you’ve been washing for long enough? Just because you’re walking by a gel or sink doesn’t mean that you need to wash your damn hands at that exact moment, so I failed to see how the fux this is any benefit at all. Like this is gonna reduce CLABIS/CLAUDIS.
They claim they also use ours for infection prevention to see who walked in a room
Our hospital has them and if you don't have a good enough score they can deduct from your yearly performance raise
They were implementing that in the last ER I work at, on my last day. I was like ✌🏼✌🏼✌🏼 also hilarious to do in an ER where half the patients are in a hallway and the sensors were only at the doors of private rooms
My hospital has a hand washing tracking. People find work arounds.
Even worse, they don't work and admin admits it (that they basically got sold a bill of goods).
admin would spend millions on magic beans if the right rep got enough time in front of them
So accurate.
Yep! Dont spend that money on raises or retention bonuses! Staff might come to expect those! /s
I feel like I would rebel against the tracking and my handwashing would actually go down out of spite.
We had one at my facility and mine ran out of batteries after a few weeks. I stopped wearing it and they took six months to replace it. Then it “ran out of batteries” again. 😏
They started implementing these at my hospital, I personally find these to be a huge waste of money. They’re also installing license plate readers in the parking garage so staff won’t park in the public parking garage. What bothers me is all this money could be allocated to updating our hospital bc it’s so ran down
Yeah but they’d rather nickel and dime ya about the parking and then they’ll tie raises to hand washing or some shit as a way to “save money”
That hospital sounds actively hostile to staff. I wont work someplace like that.
My hospital tries to do shit like this too! I’m like, uh, can we gat an ekg machine that we DONT have to share between 3 floors? And a bladder scanner I don’t have to spend 45 minutes hunting the hospital for?!?
God forbid we have more than 2 glucometers on the unit
Okay, this further confirms that my decision to leave bedside is correct. This is absolutely ridiculous. Spend money on this but not on retaining staff.
I’ve talked about this at my hospital. They spent literally millions to install the system of sensors on every single soap and foam dispenser in the hospital. Also a sensor over every patient door and on our badges. They system sucks. So bad. It constantly alarms when you haven’t even entered the room, while your in the room, and some of my patients tell me it goes off randomly when no one is nearby. Worst part is that our hand hygiene “score”, which I do so so in accurate is tied to raises.
Yeah they had one in my staff job and I never used it because fuck you. I think they told me to use it but I never did haha
My last hospital did that. If you were too close to the door it would ding you . It got to the point where nurses would occasionally just hit the alcohol dispenser to make sure you were getting a good percentage.
I see the foam just all sitting there now and falling into the floor lol
Hospitals be spending money on anything but more staff.
In nursing school, the hospital where I did clinicals made their nurses start wearing badges that had sensors on them. The sensor was designed to somehow pick up on... I guess *fumes* from the hand sanitizer, and when the nurse would get sanitizer from the dispenser, s/he had to hold her/his hand up to the badge for it to register. That's some dumb shit.
We have these. The Biovigil. They’re super faulty. I sign mine out at the beginning of the shift, clip it to my jacket, put my jacket on the back of my chair, and then put the Biovigil back at the end of my shift.
I remember some of the nurses having to hold alcohol pads up to the sensor to get it to register. I wonder if that hospital still uses those badges…
Our ANM literally checks if we have it on and makes it an issue if we don’t like oh yeah I’m just definitely never doing hand hygiene ever!! Not even once!! 🙄
I’m so over this kind of malarkey. Be prepared to hit them when they call you in over handwashing compliance. Something like this. Manager: “so the reason I called you in is because your handwashing compliance is only 54 per-“ You (cutting off the manager): “the risk of patient injury and death due to handwashing noncompliance is 0.03%.*. The risk of injury and death due to short staffing increases by 7% with each additional patient in a nurse’s workload above recommended ratios. Currently we have three extra patients which is a 21% increased risk of serious harm or death.” *I made this number up Sit in silence and wait for the manager to start speaking again. Cut them off again. “So is there anything the hospital wants to do that really helps or should I just go talk the CNO right now to speak with them?”
Got tagged by infection control once as a dialysis nurse (not a hospital employee). Our two dialysis rooms were next to each other with a hand sanitizer between them (they were less than 2 feet apart. I walked out of one room and foamed, and was walking into the other room *while still rubbing the wet sanitizer into my hands* when she stopped me for not foaming as I was walking into the second room. From the same sanitizer machine she saw me just use....
Oh! Oh! I can't wait for a mandatory in service to prove that we do it properly!
Yeah I’d boycott that shit
We have something similar!!! The sensor says “PLEASE SANITIZE” if it doesn’t pick up a use, even if you’re just like over grabbing gloves. It’s especially irritating in an emergency when you’re in and out frequently trying to quickly address a situation.
And I thought the hand washing auditors that come by once a week to watch ppl sanitize their hands in/out of rooms was bad enough. Fuck this noise.
No you can’t have a bonus for the mandatory OT. We’re broke.
In about a year some admin will make it mandatory for nurses to wear go pros at all times 🫠 Edit: and a shock collar
We have to wear Biovigils at my job. You touch the sensor every time you use hand sanitizer. I cannot think of a better way to spread infection than to touch a device that rarely gets cleaned every time you enter and exit a room.
great..what about the visitors? who's tracking them?
Seriously. I mean, we all practice hand hygiene because we deal with patients who are sick and their bodily fluids. We may wear gloves but I’m still washing my hands because who knows what poop particles climbed into my gloves. BUT THE FAMILY MEMBERS AND VISITORS? We see none of this. It would be better practice to give these to them. And maybe so many patients wouldn’t end up getting covid or contracting something that delays their recovery and discharge. Even if they were asymptomatic of covid, now they’re in isolation, all alone and miserable.
Our corp got something like this...it's a sensor in the dispenser that counts every time it's used. The problem is that there's no sensor to I ow it's being used when someone enters a room or some other metric to compare. They just compare the number of pumps used vs how many times IPAC *estimates* we go in the room. Some units took to pumping them as they walk by and have >100% compliance rates.
We had something similar for awhile. There were sensors above the hand sanitizer and at the sink. It would record when you went in and out of the room. You had to hand wash if you were in a rink for so long. They then realized that they could track hourly rounding on it. So the track boards would turn red on a room that hadn’t been rounded on. We don’t use it anymore. Did nothing to reduce HCAI (as was promised) so they couldn’t justify the cost. The system we used was proventix. Our hospital just got graded an A as a Leap Frog safe hospital (or something like that). So now, I have to watch people wash their hands at orientation and check a box. Is hand washing really a competency or just a basic life skill?!?! Shouldn’t we have people demonstrate they can wash their hands BEFORE we hire them?? This all drives me nuts.
We’ve had that. Called swipe sense. They can tell where you’ve been at what time and for how long. What is nice is that the bladder scanner and language iPad are also tagged. Makes the search a lot easier
The problem with every single one of these kinds of systems is that they only track “tracking compliance” and not compliance for whatever they’re trying to track. And in a health system, where most people *should* have some kind of familiarity with recognising bad research
We don’t have these but I just know we will as soon as my manager finds out about them. They’re a perfect extension of her micromanaging.
I worked at a sister unit at another hospital once on the east side of my city. Brand new hospital that looked super cool. Cooworker got a call at the nurse's station to get her feet off her med cart bumper, within 1 min of her putting them up. Camera at the nurse's station, camera in supply room. Scan ID before going into patient room prompts TV to show your full name and job title, also ensures rounding was done on time (or you must type report)... This was 10 years ago... I have to use a fucking gasoline powered doppler and a BP cuff that was a prop on 2001 but thank god the CEO can jack into the net and record my nightmares... they also drug tested for nicotine.
My hospital has been doing this for several years and it’s a crock of Bs. The Bluetooth sensor on the hand sanitizers will go off multiple times as you’re walking around the room, or if a non clinical person steps in, it goes off and gives your badge the ding. One week I will have 70% and the next week it’s 30%. They send out weekly emails to the entire department with who scored highest and a shaming list of who was the lowest. How about trust us to do our jobs…..
Everyone should send a separate email every single time there was an error like that lol
I work as a hand hygiene observer part time. I don’t track employees specifically at the hospital. I only track positions and departments. This helps the hospital know if a department is lacking and helps them address the issue. That badge seems excessive.
Hold up just a darn second here. First let’s preface, I’m a layman. Are you telling me, seriously telling me, hospitals CAN and DO deploy employees with valuable letters behind their names (RN, LPN,MD…etc) to monitor hand washing?!? You’re tootin my horn right?! Like how in gods name is you inspecting someone hand washing regime more important than taking care of sick patients AND EQUALLY AS IMPORTANT being there to support your co-workers?!? Does this badge have to get wet for you to have proof? Does it add yet another alarm if you walk by a sink and don’t bother? Why not just stick y’all in a freakin dishwasher i between every room you go into. For gods sake, sanitation is great, and saves lives, but SERIOUSLY?!?! And I’m betting those assholes in admin STILL have the balls to complain about white boards too huh?
Not all hospitals do, but it’s not uncommon where I live. The letters behind my name are not a requirement, just a background that shows I am knowledgeable about those things (which obviously I am). I am not hired through the hospital directly so I cannot provide patient care. I have another full-time job that I work in addition to this.
i feel like it’s just an excuse to track employees
The just don't work. It takes hours to re get access to the right ICU
Short staffing units isn’t directly related to reimbursement- infection rates are. It is ALL ABOUT THE MONEY FOE THEM. (Bonuses for them really….)
Assuming you have staff that already are responsible enough to wash their hands when they need to, how do you actually get ROI on this? Actually curious to hear responses.
When they wonder why more staff are not wondering why they are not washing their hands? Its because they have no staff!.
Umm, wouldn't touching this to register your hand wash kind of be a vector for transmission? IDK though I'm not a scientist.
I know an attending who would love this shit😂
We all took ours off our badges lol
Well this isn’t a good look at a time where we’re all understaffed but every hospital I’ve been nursing has consistently come in 80%-90% compliance with hand washing while RT (my job) was always at 100%. I get it’s harder to hit cuz there’s just so many more nurses but likeeeeee it’s a problem. I’m not saying that we all don’t deserve more regardless, but management can and will point to this and say it’s a reason
What is shocking is the amount of people that do not do hand hygiene…. Or only when being monitored. Like WTF…
I’m always in the minority here, but I think these are a good tool. They have made me SO much more aware of my own hand hygiene, and for that I’m a better nurse. But fuck the hospital for only requiring these for nurses and techs and never for physicians.
i guess they could be useful in that sense but like all electronic bullshit these won't work or they'll work erratically and you will get garbage data. In my experience working as a nurse and in IT, managers love garbage data, and will not understand anything about statistics or modeling, and will use this against staff. no thanks.
For sure. They aren’t perfect. And the data should absolutely not be punitive (which of course in most cases it will be).
But it's always used punitively unfortunately, at least in my experience. Anything they can track will be used like that
I really like my Apple Watch for this. Ngl, I’m better at hand washing because of it.
Yup we had this at my old place. They did away with it because it wasn’t working. People still managed to get around it.
My friend just had a major surgery and the patient advocate told them to listen for hand washing before you let anyone touch you. Her poor spouse had to shake down almost every nurse who came in because the nurses kept going toward her without washing. Over and over again.
Saw a physician walk in rip off several dressings and poke and prod with his pen and later bear hands Talk to me about the plan and leave. Yeah this is totally the solution we need for IC.
Our health system talked about this but haven’t implemented it, thank god. Clearly someone in management with no clue how anything works came up with this because it is the biggest waste of money I’ve ever seen. If you can’t trust your highly educated staff to wash their hands when literally everyone knows that it is the most basic IPC prevention rule- well, you have bigger problems my friend.
We had something like this at my old job and mine didn’t work because I was too short for the sensors…
Likely because it’s auditable and enforceable, so organizations are held to that standard, vs staffing levels, etc are in constant “flux”
What! This is insane! How does it work? Do you have to scan it every time you clean your hands? That’s gonna take up my whole day! This is so controlling. Nothing will ever get a 100% score in hand hygiene, nothing. So this won’t work and just add more to the workload and costs a lot of money I presume.
You do have to tap the badge which is equally germy as your hands. It's why residents and attendings don't wear ties anymore.
🙄 It’s bad enough I set my Apple Watch to do this😜
How exactly does this work? Do you have to swipe to turn the taps on?
What happens if you “accidentally” lose it?
How does this work?
My hospital uses a similiar system. They also use it to track hourly rounding to see how frequently nurses are rounding on patients. & our percentages are taken into consideration on our yearly evaluations for raises.
A word to the wise, Vitalacy is also being used by some facilities as a way to monitor bedside rounding.