Pilot study of using thermal imaging to assess hand hygiene technique

Published:September 14, 2022DOI:


      • Hand hygiene technique was assessed using a thermal camera attached to a smartphone.
      • Thermal images showed if an alcohol hand sanitizer was applied to fingers and thumb.
      • Thermal camera readings revealed temperature changes due to sanitizer application.
      • Thermal imaging shows promise as a method of assessing hand hygiene technique.


      Currently, there is no standard method for assessing hand hygiene (HH) technique. We explored the use of thermal imaging to determine if alcohol-based sanitizer (ABHS) has been applied to fingertips and thumbs, areas often missed by healthcare personnel.


      A FLIR thermal camera attached to an iPhone with FLIR app was used to obtain thermal images of volunteers’ dominant hand before and after performing HH with an ABHS. Temperature readings of the mid-palm area, and tips of 3rd finger and thumb were recorded before and at multiple time points after hand hygiene.


      In 11 of 12 volunteers, thermal images revealed significant decreases in mid-palm, finger and thumb temperatures after performing HH (P < .01 for all sites), confirming visual assessment of coverage. When HH was performed without including the thumb, a lack of colorimetric change in the thumb was visible. For persons with “cold” fingers at baseline, assessing ABHS coverage of the fingers was more difficult.


      Thermal imaging of HH performance shows promise for assessing HH technique. Additional studies involving a larger number of persons under varying conditions are needed to establish if thermal imaging can be a practical modality for teaching or monitoring HH technique.

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