Electronic Recognition of Hand Hygiene Technique and Duration

Abstract

We captured 3-dimensional accelerometry data from the wrists of 116 healthcare professionals as they performed hand hygiene (HH). We then used these data to train a k-nearest-neighbors classifier to recognize specific aspects of HH technique (ie, fingertip scrub) and measure the duration of HH events.

Electronic Monitoring Systems for Hand Hygiene: Systematic Review of Technology

“…All the 89 reviewed studies were published between 2009 and 2020, with 9 (10%) dated in or before 2010 [ 42 , 46 , 56 , 60 , 81 , 83 , 86 , 92 , 113 ], 38 (43%) dated between 2011 and 2015 [ 32 , 33 , 36 , 38 , 39 , 45 , 48 , 49 , 51 , 52 , 54 , 59 , 61 , 63 - 65 , 67 , 68 , 72 , 73 , 78 - 80 , 82 , 84 , 87 - 89 , 93 - 97 , 99 - 101 , 108 , 116 ], and 42 (47%) dated in or after 2016 [ 25 , 29 - 31 , 34 , 35 , 37 , 40 , 41 , 43 , 44 , 47 , 50 , 53 , 55 , 57 , 58 , 62 , 66 , 69 - 71 , 74 - 77 , 85 , 90 , 91 , 98 , 102 -…”

“…Hand hygiene opportunities were defined as the movement of HCWs into a patient zone when the pressure plates were activated. Furthermore, studies used electronic dispensers with other sensors, including IMUs and microphones, to recognize different types of hand hygiene events from HCWs’ daily routines [ 52 , 62 , 68 ].…”

“…Of the 14 studies, 9 (64%) studies monitored compliance with hand hygiene guidelines by attaching wearable sensors to HCWs [ 41 , 52 , 68 - 70 , 107 - 110 ]. Of these, the IMU was the most popular sensor and was used in 89% (8/9) of studies with several supplementary sensors.…”

“…As mentioned above, the IMU can measure a body’s specific force, angular rate, and orientation. Approximately 44% (4/9) of studies used the IMU of wristwatches to collect physical signals during hand hygiene events and classified hand motion within a certain time frame as one of the several individual steps of the 6-step hand hygiene techniques [ 52 , 68 - 70 ]. In addition, microphones have been combined with IMUs to evaluate hand hygiene performance, as the additional audio data could further improve the system accuracy [ 70 ].…”

The relationship between hand hygiene and health care-associated infection: it’s complicated

“…Ineffective hand hygiene technique may result in a hand hygiene intervention failing to affect the rate of MDROs. 58 The effectiveness of hand hygiene with ABHR to remove MRSA from fingertips relies on the technique of several of the above poses during approximately 20 seconds of rubbing. After contact with patient’s environment, 10% of HCWs tested positive for MRSA on their fingertips of whom 41% had used ABHR or chlorhexidine soap wash. 59 When the aim of an intervention is to reduce HAIs (outcome factor) through hand hygiene (study factor), then the definition of hand hygiene may need to consider the inclusion of the technique.…”