Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China.
Department of Hospital-Acquired Infection Control, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China; Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, The Forth Medical College of Peking University, Beijing, China.
Am J Infect Control. 2023 Mar;51(3):313-318. doi: 10.1016/j.ajic.2022.07.008. Epub 2022 Jul 19.
A large variety of electronic hand hygiene monitoring systems (EHHMS) are being developed and applied in health care settings. Monitoring hand hygiene (HH) opportunity at bed-level has been the key technical challenge. Accuracy evaluation needs more attention as the prerequisite upon widespread acceptance and adoption.
For the first time, we explored, debugged and upgraded an EHHMS based on ultra-wide bandwidth (UWB) which can obtain HH opportunities at bed-level. The real-time positioning and electronic fence of UWB technology was applied for EHHMS. The accuracy of EHHMS was compared with the simultaneous manual direct observations in real-world clinical setting. Sensitivity and specificity were calculated for EHHMS capturing HH action and opportunity.
Two generations of EHHMS were constructed. For the first generation, the system properly recorded 84% and 78% of the pre-identified HH actions and opportunities performed by experimenters. For the second generation, sensitivity and specificity of the system capturing HH action were 89% (84.83-92.36) and 100% (98.26-100.00), respectively. For capturing HH opportunity, the system showed the sensitivity and specificity of 86.52% (82.52-89.89) and 88.10% (84.14-91.36)), respectively.
The EHHMS based on UWB could accurately identify HH action and opportunity with equivalent accuracy compared with simultaneous direct observation.
各种电子手卫生监测系统（EHHMS）正在开发和应用于医疗环境中。监测床边手卫生（HH）机会一直是关键的技术挑战。准确性评估需要更多的关注，因为这是广泛接受和采用的前提。
我们首次探索、调试和升级了一种基于超宽带（UWB）的 EHHMS，该系统可以在床边获取 HH 机会。UWB 技术的实时定位和电子围栏被应用于 EHHMS。在真实的临床环境中，将 EHHMS 的准确性与同时进行的手动直接观察进行了比较。计算了 EHHMS 捕捉 HH 动作和机会的敏感性和特异性。
构建了两代 EHHMS。第一代系统正确记录了实验者进行的 84%和 78%的预识别 HH 动作和机会。对于第二代系统，系统捕捉 HH 动作的敏感性和特异性分别为 89%（84.83-92.36）和 100%（98.26-100.00）。对于捕捉 HH 机会，系统显示敏感性和特异性分别为 86.52%（82.52-89.89）和 88.10%（84.14-91.36）。
基于 UWB 的 EHHMS 可以准确识别 HH 动作和机会，与同时进行的直接观察具有同等的准确性。
