Design and evaluation of a hand hygiene prompting system for use in the home

Design and evaluation of a hand hygiene prompting system for use in the home

Regular hand hygiene is linked to the reduction of infectious disease transmission but can be overlooked or forgotten – especially at home. Automated prompting systems have been shown to improve hand hygiene compliance in clinical environments, but this approach has never been investigated in private residences, as far as we are aware. The objective of this project is to design and evaluate a hand hygiene prompting system for use in the home.

Hand hygiene is a simple, essential strategy for reducing the risk of infection that has gained importance with COVID-19 [1] [2]. However, it is surprisingly difficult to get people to wash their hands. Studies within healthcare settings have reported hand hygiene compliance rates as low as 3% within the ICU [4] with average rates in the range of 25%. Recently, hand hygiene prompting systems have shown that hand hygiene compliance can be quickly doubled in various healthcare settings.

A commonly implemented method of recording and promoting hand hygiene in a hospital setting is through direct observation oh HW activities [5]. This method is impractical within a home setting as it requires a trained observer to be present. Technologies which measure the amount of product used or on the surface of the hands are also used [3]. The measurement of product used from the system is inaccurate since it does not account for spillage, while product detection/hand wash sensors have proven to be somewhat effective in quantifying and promoting hand hygiene – but are typically separate systems attached to the user’s hands. The most effective technological methods are RFID sensor nodes, communicating with RFID tags in real time accurately determining the position of individuals [3]. A similar technology developed and evaluated by Pong et al. was able to track participants and prompt the users to wash their hands if a HW opportunity was missed [Pong – ref]. This system showed great promise as the prompting system resulted in a 67% compliance rate compared to the 9% baseline observed in other studies [4].

However, to the best of our knowledge, no one has investigated the use of a hand hygiene prompting system for at entrances to private residences. Such a system could ensure that infectious diseases are unable to enter the home on an individual’s hands and reduce the chances of infection to all residents in the home.

The objective of this project is to design and evaluate a home hand hygiene prompting system for use in the entrances of private residences to determine if it can improve the proportion of time individuals sanitize their hands when entering the home.

We expect to find significant differences for hand hygiene rates between Baseline and Prompting period for the Intervention group but not for the Control group. We also expect to find a significant main effect for group. This would indicate the hand hygiene prompting system was able to improve compliance and that a system like this may be beneficial for reducing the risk of transmitting infectious diseases like COVID-19 within the home.


Paul Kumar, Tilak Dutta