Hand hygiene has been empirically proven to prevent cross-transmission of infection, which has led to the development of global guidelines such as the World Health Organization’s ‘My 5 Moments for Hand Hygiene.’ Because of the relatively recent launch of these guidelines (2009) technology designed to assist in measuring hand hygiene compliance appears not to fully acknowledge the influence of the WHO 5 Moments for hand hygiene Consequently, they may not be fit for purpose (FFP). This paper uses a review of the literature on current hand hygiene technology to assess the extent to which these are FFP based on these global guidelines. The results show that there are a variety of technologies available to assist with the monitoring and measurement of hand hygiene levels. However, none appear to explicitly achieve detection of all WHO 5 Moments for hand hygiene, limiting their effectiveness. The authors conclude that a systems approach offers a potential aid for developers aspiring to meet domain specific FFP requirements. Human factors may help guide such developments to meet user and context specific needs.
Anon. (2011) System given gentle nudge on handwashing. Health Facilities Management24(2): 6.
2.
Anon. (2012) Product preview. Supply House Times55(7): 12–14.
3.
ArmellinoDHussainESchillingMESenicolaWEichornADlugaczYFarberBF. (2012) Using high-technology to enforce low-technology safety measures: the use of third-party remote video auditing and real-time feedback in healthcare. Clinical Infectious Diseases54(1): 1–7.
4.
BauerTMOfnerEJustHMJustHDaschnerFD. (1990) An epidemiological study assessing the relative importance of airborne and direct contact transmission of microorganisms in a medical intensive care unit. Journal of Hospital Infection15(4): 301–9.
5.
BhallaAPultzNJGriesDMRayAJEcksteinECAronDCDonskeyCJ. (2004) Acquisition of nosocomial pathogens on hands after contact with environmental surfaces near hospitalized patients. Infection Control and Hospital Epidemiology25(2):164–7.
BoyceJM. (2011) Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infection Control and Hospital Epidemiology32(10): 1016–28.
8.
CantrellS. (2012) Healthcare facilities strive to hand infections defeat. Healthcare Purchasing News36(10): 22–30.
9.
CarayonPGursesAP. (2005) A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units. Intensive and Critical Care Nursing21: 284–301.
10.
CatchpoleKMishraAHandaAMcCullochP. (2008) teamwork and error in the operating room: analysis of skills and roles. Annals of Surgery247(4): 699–706.
ChengVCCTaiJWMHoSKYChanJFWHungKNHoPLYuenKY. (2011) Introduction of an electronic monitoring system for monitoring compliance with Moments 1 and 4 of the WHO ‘My 5 Moments for Hand Hygiene’ methodology. BMC Infectious Diseases11: 151.
13.
CzyzewskiA. (2011) Infrared hygiene monitor put on trial. The Engineer296(7827): 10.
14.
DawsonC. (2013) To “Urgh” is Human… Exploring Inherent and Elective Hand Hygiene Triggers: A pilot study in the NHS. Journal of Infection Prevention14 (1) Suppl: S3-S47 Abstract 2511.
15.
DawsonCH. (2014) Healthcare professional views on the potential for hand hygiene technologies – findings from an NHS acute setting case study.
16.
DoEY-L. (2009) Technological interventions for hand hygiene adherence: research and intervention for smart patient room. In: TidafiTDortaT (eds) Joining languages, cultures and visions: CAADFutures 2009, PUM: 303–13. Available at: http://cumincad.scix.net/cgi-bin/works/Show?cf2009_303. (Accessed 13 November 2011).
17.
EckmannsTBessertJBehnkeMGastmeierPRudenH. (2006) Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect. Infection Control and Hospital Epidemiology27(9): 931–4.
18.
EdmondMBGoodellAZuelzerdWSanogobKElamaKBearmanaG. (2010) Successful use of alcohol sensor technology to monitor and report hand hygiene compliance. Journal of Hospital Infection76(4): 364–5.
19.
El ShafieSSAlishaqMLeni GarciaM. (2003) Investigation of an outbreak of multidrug-resistant Acinetobacter baumannii in trauma intensive care unit. Journal of Hospital Infection56(2): 101–5.
20.
EllingsonKPolgreenPMSchneiderAShinkunasLKaldjianLCWrightDThomasGWSegreAMHermanTMcDonaldLCSinkowitz-CochranR. (2011) Healthcare personnel perceptions of hand hygiene monitoring technology. Infection Control and Hospital Epidemiology32: 1091–6.
GhoshAAmelingSZhouJLaceyGCreamerEDolanASherlockOHumphreysH. (2012) Pilot evaluation of a ward-based automated hand hygiene training system. Infection Control41(4): 368–70
23.
GouldDJChudleighJDreyNSMoralejoD. (2007) Measuring handwashing performance in health service audits and research studies. Journal of Hospital Infection66(2): 109–15.
24.
HaasJPLarsonEL. (2007) Measurement of compliance with hand hygiene. Journal of Hospital Infection66: 6–14.
25.
Health Protection Scotland (HPS) (2009) National Hand Hygiene NHS Campaign Compliance with Hand Hygiene - Audit Report Health Protection Scotland. Glasgow.
26.
HladyCSSeversonMASegreAMPolgreenPM. (2010) A mobile handheld computing application for recording hand hygiene observations. Infection Control and Hospital Epidemiology31(9): 975–7.
KohliEPtakJSmithRTaylorETalbotEAKirklandKB. (2009) Variability in the Hawthorne effect with regard to hand hygiene performance in high- and low-performing inpatient care units. Infection Control and Hospital Epidemiology30(3): 222–5.
30.
LinLVicenteKJDoyleDJ. (2001) Patient safety, potential adverse drug events, and medical device design: a human factors engineering approach. Journal of Biomedical Informatics34: 274–84.
31.
LorenziN. (2011) Tracking changes. Health Facilities Management24(8): 36.
32.
OtterJAHavillNLAdamsNMTBoyceJM. (2006) Extensive environmental contamination associated with patients with loose stools and methicillin-resistant Staphylococcus aureus colonization of the gastrointestinal tract. In: 16th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America, Chicago, IL, 2006; abstract 159.
33.
Pessoa-SilvaCLHugonnetSPfisterRTouveneauSDharanSPosfay-BarbeKPittetD. (2007) Reduction of health care associated infection risk in neonates by successful hand hygiene promotion. Pediatrics120: 382–90.
34.
PittetDHugonnetSHarbarthSMourougaPSauvanVTouveneauSPernegerTV. (2000) Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet356: 1307–12.
35.
PolgreenPMHladyCSSeversonMASegreAMHermanT. (2010) Method for automated monitoring of hand hygiene adherence without radio-frequency identification. Infection Control and Hospital Epidemiology31(12): 1294–7.
36.
RouseWB. (2010) The Economics of Human System Integration. Hoboken, NJ: J Wiley.
37.
SahudAGBhanotNNarasimhanSMalkaES. (2012) Feasibility and effectiveness of an electronic hand hygiene feedback device targeted to improve rates of hand hygiene. Journal of Hospital Infection82: 271–3.
38.
SaxHAllegranziBUçkayILarsonEBoyceJPittetD. (2007) ‘My five moments for hand hygiene’: a user–centred design approach to understand, train, monitor and report hand hygiene. Journal of Hospital Infection67: 9–21.
39.
SaxHStewardsonAAllegranziBBoyceJMClackLLarsonELPittetD. (2012) Beyond reasonable doubt: evidence for ‘My 5 moments for hand hygiene’. British Edititorial Society of Bone and Joint Surgery. Available at: www.bjj.boneandjoint.org.uk/content/94-B/4/441/reply (accessed 6 August 2013).
TenorioARBadriSMSahgalNBHotaBMatushekMHaydenMKTrenholmeGMWeinsteinRA. (2001) Effectiveness of gloves in the prevention of hand carriage of vancomycin-resistant enterococcus species by health care workers after patient care. Clinical Infectious Diseases32(5): 826–9.
43.
van de MortelTMurgoM. (2006) An examination of covert observation and solution audit as tools to measure the success of hand hygiene interventions. American Journal of Infection Control34(3): 95–9.
44.
VicenteK. (2006) The Human Factor: Revolutionizing the Way People Live with Technology. Abingdon, Oxon, UK: Routledge.
45.
WilsonJR. (2000) Fundamentals of ergonomics in theory and practice. Applied Ergonomics31(6): 557–67.
46.
WilsonJR. (2014) Fundamentals of systems ergonomics/human factors. Applied Ergonomics45(1): 5–13.
47.
World Health Organization. (2009) WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care. Geneva: WHO Press.
