The quality of the way you clean your hands has a big impact on the number of potentially dangerous microbes that remain. Consequently, the WHO has recommended a special technique for healthcare workers that is really effective at removing the microbes. This technique is taught during the hand hygiene training process in hospitals.

Automatic Video Auditing of hand washing has shown that there are lapses in the quality of hand hygiene in hospitals, with only 16% of people using the recommended technique. Therefore, hand hygiene training must be improved upon in order to ensure compliance.

In a 3-month study, interactive technology was added to all sinks on a surgical ward to provide real-time feedback on hand washing quality to users. The interactive feedback drove a discussion of hand hygiene quality among the staff and they were challenged to achieve a good score on the system for each hand wash.

After real time feedback was added, the number of people achieving the WHO quality standard improved by over 190%. The number of hand hygiene events per patient day also increased by 147%. After 3 months, the interactive feedback was turned off and the improvement disappeared; this is probably because users “off-loaded” the task of keeping track of their technique onto the technology.



This has a couple of key implications for how we use technology to help improve hand hygiene:

  • If the role of the technology is to reduce the mental burden of remembering when and how to do hand hygiene, then the technology must be maintained in order to keep performance high.
  • If the technology is to be used for learning in a work environment, then we have to ensure that the real-time feedback on hand washing provided to learners is progressively reduced and that the technology moves toward providing real-time assessment only and not instruction. This means that the feedback needs to be customised to each learner as they develop their hand hygiene proficiency.

Access to full paper: