Toronto Rehabilitation Institute, iDAPT-Intelligent Design for Adaptation, Participation and Technology, Toronto, Ontario, Canada.
Int J Med Inform. 2011 Aug;80(8):596-603. doi: 10.1016/j.ijmedinf.2011.04.002. Epub 2011 May 20.
Inadequate hand hygiene (HH) by healthcare staff results in increased rates of hospital acquired infections in healthcare institutions, considerable waste of resources, and negative economic impact for the healthcare system. Toronto Rehabilitation Institute has developed an automated HH monitoring system that detects HH opportunities, generates HH reminding signals when it is necessary and enables hospital management to monitor individual and aggregated HH performance on ongoing basis.
To demonstrate that HH improvement is feasible with the proposed technical solution and that technology is acceptable by potential users.
The technology was installed in four rooms on a nursing unit of a larger complex continuous care hospital. The rooms were selected to make it possible to automatically follow the same nurses for the duration of their entire shift. Eleven nurses were provided with the wearable electronic HH monitors as well as with the instrumented personal wearable alcohol gel dispensers. Stationary gel dispensers installed in the unit were also instrumented with technology.
Over 145 h of testing the system automatically recorded a total of 1438 events of entering and leaving monitored rooms and indicated an average of 6.42 HH actions per hour. The baseline observational study indicated 4.2 HH actions per hour. Approximately half of the HH actions recorded by the system were performed using personal wearable alcohol gel dispensers.
The results obtained when testing the embedded HH monitoring system demonstrated the feasibility of HH improvement and proved that proposed solution merits a larger and longer clinical trial to measure the degree of improvement and the sustainability of that improvement.
医护人员手部卫生（HH）不足会导致医疗机构内医院获得性感染率上升，造成大量资源浪费，并对医疗系统产生负面影响。多伦多康复研究所开发了一种自动 HH 监测系统，可检测 HH 机会，在需要时生成 HH 提醒信号，并使医院管理层能够持续监测个人和汇总 HH 绩效。
证明所提出的技术解决方案可以实现 HH 改善，并且技术可以被潜在用户接受。
该技术安装在一个更大的连续护理医院的护理单元的四个房间中。选择这些房间是为了能够在整个轮班期间自动跟踪同一护士。为 11 名护士配备了可穿戴电子 HH 监测器以及带有仪器的个人可穿戴酒精凝胶分配器。该单元中安装的固定凝胶分配器也配备了技术。
在 145 小时的测试中，该系统自动记录了总共 1438 次进出监控房间的事件，平均每小时记录 6.42 次 HH 操作。基线观察研究表明，每小时进行 4.2 次 HH 操作。系统记录的 HH 操作中，约有一半是使用个人可穿戴酒精凝胶分配器完成的。
在测试嵌入式 HH 监测系统时获得的结果表明 HH 改善是可行的，并证明所提出的解决方案值得进行更大规模和更长时间的临床试验，以衡量改善程度和改善的可持续性。
