Hand Hygiene Monitoring Devices

Direct observation is the approach most often used in healthcare facilities to assess compliance with handwashing. Handwashing or hand sanitizing with ethyl alcohol solutions or gels have been shown in dozens of studies to be the most critical action that healthcare providers can take to reduce patients' infection risk. So it's not surprising that new ways of assessing compliance with handwashing are being explored. The problem with direct observation is that when healthcare providers know they are being observed (even if they are told that something else, such as the frequency of checking patients' armbands, is what is being observed), they adhere to best practices more often than when they are not being observed. The introduction of a new hand hygiene device that detects whether healthcare workers have sufficiently washed their hands before entering a patient’s room may change the way that handwashing compliance is assessed and monitored.

The BioVigil, a device that resembles a name badge, is being tested at Virginia Commonwealth University Medical Center in Richmond, VA. It is programmed to detect ethyl alcohol, the most common ingredient in hospital hand-cleansing solutions. When a healthcare provider enters a patient’s room, a wall-mounted sensor sends a signal to the BioVigil badge to check for ethyl alcohol. The healthcare provider then places his or her hands near the badge, which has lights that glow red if no alcohol is present or green if alcohol is detected. A red light signals the need for that person to use hand sanitizer prior to caring for the patient. The biggest limitation of this technology is that it only detects ethyl alcohol; it does not detect use of soap or other cleansers. Another consideration is the sensitivity of the device and the amount of ethyl alcohol that must be detectable in order for the badge to display the "go ahead" green light. While the idea behind the BioVigil is a good one, it will be interesting to see if this technology is adopted or falls to the wayside because of cost, complexity, and user preference.