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Nursing Information Technology Management

Advances in technology have fed the explosion of wearable devices and patient self-monitoring. How can nurses leverage this technology to promote healthy lifestyles and improved compliance with self-care and monitoring?
There are vast quantities of consumer data available today. For example, every time you use your grocery store loyalty card, data about what you purchased is collected, analyzed, and saved. This data in the hands of population health professionals can contribute to the creation of healthy lifestyle programs. However, the same data in the hands of health insurance plans could lead to higher insurance costs of denial of insurance. Should there be regulations on how these consumer data are used?
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For more than 1.5 centuries now, hand hygiene wearable technology (HH) has been continually emphasized as a critical intervention for infection prevention and control in hospital programs for patient safety. In their article “New Technologies to Monitor Healthcare Worker Hand Hygiene,” published in the Clinical Microbiology and Infection, 20 (1), Marra and Edmond (2014) explores the new technologies and innovations that have been advanced in the attempt to increase the compliance of hospital staff to the HH. The article gradually explores the evolution of HH compliance measures from the traditional visual observation methods to the latest sensor-based complex compliance measures and reminders.

Wearable devices and a healthy lifestyle

In the article, Marra and Edmond (2014) begin by accentuating the vitality of HH in any patient safety program in a hospital. They posit that while the importance HH in the hospital context was discovered over a century ago, compliance rates still flounder below 50% in most hospitals with Healthcare Workers (HCWs) pointing to lack of incentives, work overload, Skepticism of effectiveness and time constraints as the major reason for compliance. The paper then proceeds to discuss the major methods of measuring compliance to HH by HCWs. Three major common means are identified and discussed:  Observers; electronic counters; and product utilization measures. While observation was initially done with the eyes, checking the number of times HCWs visited the sink, a new mobile application called the iScrub installable on iPhone and iPod gadgets enable a continued observation of this trend. Similarly, electronic counters also check the frequency of use without checking the quality and extent of HH. This also happens to the product utilization measures that measure the amount of detergent or alcohol gel used within certain periods. The authors conclude that while these technologies have been applied in several hospitals, the HH compliance rate has remained just within the 50% range calling for the need for more comprehensive and serious systems of not only measuring but also promoting compliance.

New Electronic Systems for Wearable Devices

The article then proceeds to analyze the new electronic systems for monitoring HH. These innovations either are under testing or have been implemented by a few healthcare organizations. Firstly, there are the sensor-based technologies that use alcohol sensors to establish the level of HH compliance. To these sensors, signals are included that produce green lights on compliance and red light on failure to comply to ensure that in addition to monitoring they promote usage. The article points out that in the pilot project for implementation, compliance rates increased from 66% to above 92% showing effectiveness. These systems have also been favored by patients who support the use of sensors on toilet doors and other doorways where sinks are as an effective HH compliance monitor.

Other innovations identified include the Wifi and Zigbee based sensors placed on the HCW’s clothing and sends compliance information to a central database that is later used to summon a non-complying HCWs to answer non-compliances claims. This puts the HCWs in check and ensures reduced non-compliance cases.  Others have also suggested the use of positive deviance in hospitals to ensure that HCWs are encouraged to introduce new ways that may promote compliance amongst both themselves and the patients. It concludes by noting that while viewed as simple, HH compliance needs a multidimensional approach that not only measures but also promotes compliance among HCWs and patients.


In conclusion, Marra and Edmond present a compelling academic work that can promote HH among both HCWs and patients through technology. However, just as emphasized herein, this will only be possible if further research is done on the topic of new technology and HH. It is, however, clear that technology and innovations in the field of medicine and nursing have improved situations a great deal by improving the HH from less than 30% compliance to over 60% compliance. The paper is written in understandable simplicity and coherence, using quality references and generally well organized. Nevertheless, the authors include some irrelevant analysis that actually does not fit the heading of the title. They also fail to include a cost-benefit analysis of the technologies yet acknowledging that its cost that bars most hospitals from adopting new technology.

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