Highlights
- •An UWB based EHHMS was explored, debugged and upgraded for the first time
- •UWB with electronic fence can identify a clear and controllable boundary of bed area
- •The EHHMS had the capability of obtaining hand hygiene opportunity at bed-level
- •Accuracy of EHHMS comparing with direct observation was evaluated in clinics
- •The EHHMS showed excellent sensitivity and specificity for capturing HH performance
Abstract
Background
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.
Methods
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.
Results
Two generations of EHHMS were constructed. For the first generation, the system properly
recorded 84.00% 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 89.00% (84.83–92.36) and 100.00% (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.
Conclusion
The EHHMS based on UWB could accurately identify HH action and opportunity with equivalent
accuracy compared with simultaneous direct observation.
Keywords
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© 2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
