A registered nurse that goes by the username @the.nurse.erica on TikTok recently posted about how her employer uses technology to track how many times she washes her hands. The story quickly went viral as thousands of nurses shared their opinions in the comments section. Some providers embraced the idea as a way of improving sanitation and reducing the spread of disease, but others called it an invasion of privacy.
A Watchful Eye
The nurse demonstrated how the hospital automatically keeps tabs on her hand-washing routine. She said there are remote sensors in each patient’s bed and all the hand sanitizer and soap dispensers.
“Once your badge detects that you’re within so many feet of a patient’s bed, you have a certain number of seconds to either sanitize or wash your hands, or your badge will start beeping at you,” she explained.
She said that the software program automatically generates a report at the end of each week and sends it to the nurse’s manager. Each report contains a “hand-washing score” based on how many times the person used these dispensers on the job.
The TikToker complained that the hospital had gone too far, but not everyone agreed. The video quickly racked up over 1.1 million views. Nurses flooded the comments to share how they felt about the idea.
“I don’t think that’s a bad idea honestly,” wrote one user.
“I worked as a CNA for a long time and I actually think this is a great idea,” wrote another.
Some argued that nurses should already be washing hands and that this technology only serves as a reminder.
“So they are making sure you are clean before you touch patients? I don’t see the problem with that,” wrote another person.
“As someone who works in healthcare, it is crazy how many healthcare professionals said they don’t wash or sanitize their hands in between patients,” said another.
But plenty of users also took issue with the notion, comparing it to Big Brother.
“This has the same energy as putting cameras in teachers’ classrooms…,” one user said.
“This is so patronizing to nurses,” said another.
“Crazy! They can’t trust nurses to wash their hands?” a third user questioned.
Others argued that the hospital should be more focused on solving other issues, such as the current staffing shortage.
“Isn’t there more things to worry about like safe patient ratios ?♀️,” one user said.
Another person questioned whether the device would lead to more stress for nurses.
“Imagine running into a room to stop a (patient) from falling, or suction some(one) who’s choking, or find a (patient) seizing. All to have (your) badge fkn beep at (you)..,” they wrote.
The Tracking Game
Smart sensors that track handwashing have been around for several years. Hospitals that use this approach say it’s one of the best ways to prevent hospital-acquired infections (HAI), which are diseases and germs that spread inside healthcare settings.
These infections can be expensive to treat. A recent study published in JAMA Internal Medicine shows that hospitals spend on average $45,814 per central line-associated bloodstream infection, and $11,285 for every Clostridium difficile infection.
In 2017, Ballad Health decided to tackle the issue by rolling out a new system from a startup known as SwipeSense. The company first launched the program at Franklin Woods Community Hospital in Johnson City, TN.
It works by implanting a sensor in each employee’s badge. The sensor communicates wirelessly with location hubs throughout the hospital that track when workers enter and exit patient rooms. The hospital also installed new drip trays under that hand sanitizer and soap dispensers, each fitted with a sensor.
The system tracks whether providers sanitize their hands within 60 seconds of entering the patient’s room. Hospital and nurse managers can then access the results to see which departments are complying with the latest hygiene requirements and which ones are falling behind.
Ballad Health has since implemented the program at six of its hospitals. SwipeSense says it charges facilities a subscription fee based on the number of beds.
To counter any negativity among staff members, hospital managers say they aren’t using a punitive approach. Instead, they offer “fun incentives” like pizza parties to encourage providers to wash their hands.
But executives at Ballad and SwipeSense say finding the root causes of poor hygiene is often more nuanced. It’s not always about reminding providers to wash up. For example, some departments may be understaffed or lack access to hand sanitizer.
Klaus Nether, executive director of high reliability product delivery at the Joint Commission Center for Transforming Healthcare, said the system isn’t meant to be punitive in any way. If departments are having trouble maintaining compliance, it should spark a conversation among managers in terms of how the situation can be improved.
“It isn’t as simple as the solution or best practice that we implement here is now going to work” elsewhere, he said.
Companies will need time to sift through the data when addressing the issue.
“You have to take the time to really understand it, because it is more complex than just reminding someone to wash their hands,” Nether said.