Be it pandemic or not, one sector that must compulsively follow hand hygiene is the healthcare sector. While we are familiar with the traditional ways of washing hands, in-out, out-in, up, down, all around, and sanitizing them, when it comes to healthcare, there have been situations where this ritual gets knowingly or unknowingly compromised. This is a pain point, especially for personnel from the healthcare space as they are constantly in contact with contaminated surfaces and have even more reason to avoid cross-contamination. Clean India Journal is revisiting the topic of hand hygiene to understand the latest innovations that can simplify processes or create reminders for doctors who will be examining patients in the operation theatre (OT), out-patient ward (OPD), or casual ward.
Clean India Journal interacted with a couple of experts in this field to delve into the technological interventions and various solutions that have simplified the process of remembering to wash hands and doing it in a much simpler way to keep them de-contaminated.
The father of hand hygiene, Ignaz Semmelweis and later Florence Nightingale advocated handwashing and other hygiene practices to reduce death and infection in hospitals. Sadly, this important practice received little attention until recent years with an uptick in foodborne outbreaks and hospital-associated infections.
Dr Ashok Kumar Khandelwal, VP & MD of Anandaloke Multispecialty Hospital, shares that studies have shown the most common causes for noncompliance with handwashing by healthcare providers include insufficient time, work overload, inadequate knowledge, sinks, and soap dispensers being unavailable at convenient locations, and scepticism about the role of hand hygiene.
Mobile applications and wearables provide a scalable and inexpensive method for recording and analyzing hand-hygiene observations.
Dr Ashok Kumar Khandelwal
Technology-driven hand-hygiene compliance monitoring (HHCM) systems are encouraged among healthcare organisations, accrediting and regulating authorities, and patient support groups. Electronic sensors use various RFID technologies (Wi-Fi, Bluetooth, ZigBee, and ultrasound). These sensors provide the advantage of detecting hand hygiene before patient care and sending automatic reminders or alerts to perform the same. Real-time feedback and automated reports of activities related to hand hygiene compliance are generated. The drawbacks include expense and high maintenance costs. Video surveillance cameras can record all activities related to hand hygiene compliance and deliver real-time feedback to healthcare workers. However, employee privacy and confidentiality may be compromised.
Wearable devices could be worn by healthcare providers. They function on wireless identification and record hand hygiene with alcohol hand rub using electronic dispensers in patient care areas. These devices offer the development of machine learning applications to support healthcare staff, IPC education, and audits. However, wearable devices worn on wrists may be a potential source of infection.
Antimicrobial coatings (AMC) are used in the healthcare environment to prevent hospital-associated infections (HAIs). High-touch surfaces in patient care areas are linked to HAIs by acting as vectors for the transmission of microbes. To mitigate this problem of HAI, these high-touch surfaces can be coated with antimicrobial compounds. A drawback of this coating includes the potential risk of the development and spread of antimicrobial-resistant bacteria.
AI applications for hand hygiene compliance monitoring involve systems using camera-based augmented reality and gamified learning to train and monitor hand hygiene processes with resultant improvements in compliance. A mobile kiosk or smartphone app can be used by healthcare staff at a suitable time to obtain immediate and individualized performance feedback. AI applications and machine learning can use data to predict future outbreaks and suggest IPC interventions.
Hemant Kumar Singh, Manager of Housekeeping at Medanta Hospital, opines that condition monitoring measures, such as staff satisfaction, may be a useful addition to existing hand hygiene monitoring measures and add meaning to the recipients of the feedback data. Adding goal setting, reward incentives, and accountability strategies can lead to further improvements in hand hygiene.
Hand hygiene innovations in healthcare settings across India, including integrating technological solutions like automated dispensers, real-time compliance monitoring, and data-driven feedback systems, have significantly improved adherence to hand hygiene protocols. The government’s increased focus on public health education and the adoption of global best practices have further bolstered the importance of hand hygiene. As India continues to innovate and implement these critical measures, the future of healthcare looks promising with the potential for greater patient outcomes and a healthier nation.
Hand-mediated transmission of microorganisms is a major factor in the spread of healthcare-associated infections.
Hemant Kumar Singh