Smartphone text message service to foster hand hygiene compliance in health care workers.
BACKGROUND
Health care-associated infections are a major worldwide public health issue. Hand hygiene is a major component in the prevention of pathogen transmission in hospitals, and hand hygiene adherence by health care workers is low in many studies. We report an intervention using text messages as reminders and feedback to improve hand hygiene adherence.


MATERIALS AND METHODS
The study is a historical comparison proof-of-concept study. Eighteen health care workers were monitored during 12 months by a radiofrequency identification system. Afterward we sent 2 types of text messages, congratulation or encouragement, and we studied the evolution of hand hygiene adherence.


RESULTS
We recorded 15,723 hand hygiene opportunities, 8,973 before intervention and 6,750 during and after the intervention. Using a multilevel logistic regression analysis, we found a significant increase in hand hygiene adherence during the intervention (odds ratio, 1.68) compared with the historical period.


DISCUSSION
Despite limitations due to the type of study, a text message encouraging personnel to be more vigilant is effective in increasing hand hygiene adherence in health care workers.


CONCLUSIONS
Text message feedback should be incorporated into multimodal approaches for improving hand hygiene compliance.
['Kerbaj|Jad|J|', 'Toure|Youssoupha|Y|', 'Soto Aladro|Alberto|A|', 'Boudjema|Sophia|S|', 'Giorgi|Roch|R|', 'Dufour|Jean Charles|JC|', 'Brouqui|Philippe|P|']
D001521:Behavior Therapy D019983:Guideline Adherence D063373:Hand Hygiene D006282:Health Personnel D006302:Health Services Research D006801:Humans D000075082:Proof of Concept Study D017010:Reminder Systems D000068997:Smartphone D060145:Text Messaging
Intervention Reminders Feedback Encouragement SMS