Machine learning hand hygiene notifications improve adherence to 100%

A machine learning, real-time hand hygiene notification system improved participant adherence to 100 percent, according to a study published April 9 in the Journal of Hospital Infection.

In this study, researchers examined the feasibility and impact of a real-time machine learning system that provided hand hygiene notifications.

“Hand hygiene is widely recognized as the most effective way to reduce the transmission of healthcare-associated infections,” wrote first author Roel Geilleit and colleagues. “Hand hygiene compliance needs to be monitored to assess changes in performance over time. However, mainly due to limitations with the monitoring, it is difficult to obtain high quality evidence on the effectiveness of hand hygiene interventions. Direct, discreet observation of hand hygiene compliance is considered the gold standard. However, less than 1.5 percent of all hand hygiene opportunities are observed in practice because of the high demands on manpower resources.” 


Researchers developed an infrared-guided sensor system to notify clinicians to perform hand hygiene before meeting with patients. Baseline hand hygiene in an outpatient clinic was compared to results in both the notification system with and without auditory notifications, which continued until hand hygiene was performed or until 15 seconds had elapsed.

The average baseline hand hygiene was measured at 53.8 percent before introduction of the system. The auditory system boosted overall hygiene performance to 100 percent. The non-audio system also increased hand hygiene to 80.4 percent.

“This study demonstrated that a real-time hand hygiene notification machine learning system was able to increase hand hygiene compliance in outpatient clinics by almost two-fold,” concluded Geilleit and colleagues. “Relative to the full implementation, when a notification with lower intensity and duration was activated, the hand hygiene compliance was reduced by 20 percent. The system also increased just-in-time hand hygiene compliance by 17 percent and was estimated to prevent 440 ILIs per annum associated with pediatric patients visiting outpatient clinics. Additionally, the real-time notification system provided the opportunity to audit all hand hygiene opportunities, at a relatively low cost compared to the current gold standard of observational auditing.”