Graham C Hufton’s research while affiliated with Toronto Rehabilitation Institute and other places

Different approaches to implementation of hygiene compliance monitoring are presented. The architecture and operation of an embedded distributed system for hygiene compliance monitoring are described. The performance of the system does not depend on the number of monitored areas, number of caregivers being monitored, and no network infrastructure is required. Note to Practitioners-The embedded system for hand hygiene monitoring system was designed to be used in healthcare institutions. The main function of the system is to monitor hand hygiene compliance according to the rules (based on the Ministry of Health and Long-Term Care guidelines) implemented as a part of the system software. The main components of the system are wearable electronic monitors, disinfectant dispensers, and monitored zones installed in the areas essential for hand hygiene compliance.

The commentary was prepared in response to the manuscript "Healthcare-Associated Infections as Patient Safety Indicators," by Gardam, Lemieux, Reason, van Dijk and Goel. Healthcare-associated infections are a severe patient safety hazard. Current patient safety initiatives targeting increased healthcare worker hand hygiene to prevent some of these infections have had limited effect. This commentary describes recent advances in electronic sensing and computational power that have provided new options to increase hand hygiene compliance as a step toward reducing healthcare-associated infections. Smart electronics can provide reasoning about a healthcare worker's circumstance and prompt the worker to perform hand hygiene when necessary. These novel approaches in technology development have tremendous potential to enhance the hand hygiene of healthcare workers and can support the prevention of this significant problem for patients in our hospitals.

Transmisssion of infection within healthcare institutions is a significant threat to patients and staff. One of the most effective means of prevention is good hand hygiene. A research team at Toronto Rehabilitation Institute, Ontario, Canada, developed a wearable hand disinfection system with monitoring capabilities to enhance hand wash frequency. We present the findingsof the first phase of a larger study addressing the hypothesis that an electronic hand hygiene system with monitoring and reminding propertieswill increase hand hygiene compliance. This first phase focused on the acceptability and usability of the wearable electronic hand wash device ina clinical environment. The feedback from healthcare staff to the first prototype has provided evidence for the research team to continue with the development of this technology.