JMIR Publications

ABSTRACT

Objectives: To conduct a systematic review and meta-analysis to evaluate the effects of hand hygiene intelligent technology implementation in hospitals.

Methods:

We searched MEDLINE, Embase, CINAHL, Web of Science, the Cochrane Library, VIP Database and CNIK from inception to October 2021. Two reviewers independently screened, selected and extracted data. A meta-analysis was conducted using RevMan 5.3 and STATA 15.1 softwares. The systematic review protocol was registered.

Results:

33 studies were included for review including 2 RCT and 31 quasi-experimental studies. 66.7% of studies published in the past 5 years. Compared with usual care, the intervention of hand hygiene intelligent technology improved hand hygiene compliance of health care workers (risk ratio= 1.64, 95% CI 1.50 to 1.74, p< .0001), reduced health care-associated infection rates (risk ratio= 0.25, 95% CI 0.19 to 0.33, p< .0001), and was not associated with multi-drug resistant organism detection rates (risk ratio= 0.53, 95% CI 0.27 to 1.04, p= 0.07). Three covariates of publish year, study design and intervention were not the factors to hand hygiene compliance or hospital-acquired infection rates analyzed by meta-regression. Sensitivity analysis showed stable results except the pooled outcome of multi-drug resistant organisms detection rates. The quality of three evidences indicated a lack of high-quality studies.

Conclusions:

Intelligent technology could be applied in the future as the essential way to improve hand hygiene. However, low quality of evidence and important heterogeneity were observed. Larger clinical trials needed to evaluate the impact of intelligent technology on multidrug-resistant organism detection rates and other clinical outcomes.