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Evaluation of an Electronic Device for Real-Time Measurement of Alcohol-Based Hand Rub Use

  • John M. Boyce (a1) (a2), Timothea Cooper (a1) and Michael J. Dolan (a3)

Observational surveys of hand hygiene compliance are time consuming. Measuring the use of a hand hygiene product is a less time-consuming method of monitoring the frequency of hand hygiene performance.


To evaluate the usefulness of electronic devices for monitoring alcohol-based hand rub use.


Prospective observational trial.


A university-affiliated teaching hospital.


Prototypes of an electronic device designed to record each time a dispenser is used (hereafter referred to as a hand hygiene event) were placed in alcohol-based hand rub dispensers on the general medical ward and in the surgical intensive care unit. Data were downloaded wirelessly to a data logger and then uploaded to a dedicated Web site for analysis. Alcohol-based hand rub dispensers were located in patient rooms and in corridors.


During a 6-month trial, 105,462 hand hygiene events occurred in the surgical intensive care unit, and 44,845 events occurred on the general medical ward. The dispensers located in patient rooms accounted for 47% of the hand hygiene events performed in the surgical intensive care unit but for only 36% of events on the general medical ward (P<.001). The dispensers most often used were located in corridors. Hand hygiene events were most common on Tuesdays, Wednesdays, and Thursdays, between 7:00 AM and 11:00 AM.


The use of these electronic devices provided an efficient and accurate method of monitoring the frequency of alcohol-based hand rub performance on the general medical ward and in the surgical intensive care unit, and yielded more detailed information on usage patterns than did expressing use as liters per 1,000 patient-days. The wireless downloading of data from dispensers required a limited amount of time, and the dedicated Web site facilitated data analysis. Such devices should prove useful in monitoring the impact of various interventions on the frequency of hand hygiene performance.

Corresponding author
Hospital of Saint Raphael, 1450 Chapel Street, New Haven, CT 06511 (
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3. D Pittet , P Mourouga , TV Perneger ; members of the Infection Control Program. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126130.

4. JP Haas , EL Larson . Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:614.

5. T Van De Mortel , M Murgo . An examination of covert observation and solution audit as tools to measure the success of hand hygiene interventions. Am J Infect Control 2006;34:9599.

6. D Pittet , S Hugonnet , S Harbarth , P Mourouga , V Sauvan , S Touveneau . Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:13071312.

7. M McGuckin , A Taylor , V Martin , L Porten , R Salcido . Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Am J Infect Control 2004;32:235238.

8. EL Larson , E Early , P Cloonan , S Sugrue , M Parides . An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med 2000;26:1422.

11. JM Boyce , C Ligi , C Kohan , DG Dumigan , NL Havill . Lack of association between the increased incidence of Clostridium difficile–associated disease and the increasing use of alcohol-based hand rubs. Infect Control Hosp Epidemiol 2006;27:479483.

12. T Eckmanns , F Schwab , J Bessert , et al.Hand rub consumption and hand hygiene compliance are not indicators of pathogen transmission in intensive care units. J Hosp Infect 2006;63:406411.

13. KB Kirkland , JM Weinstein . Adverse effects of contact isolation. Lancet 1999;354:11771178.

14. HT Stelfox , DW Bates , DA Redelmeier . Safety of patients isolated for infection control. JAMA 2003;290:18991905.

. . ;:–.15. JM Broughall An automatic monitoring system for measuring handwashing frequency J Hosp Infect 1984 5 447453

16. AK Venkatesh , MG Lankford , DM Rooney , T Blachford , CM Watts , GA Noskin . Use of electronic alerts to enhance hand hygiene compliance and decrease transmission of vancomycin-resistant Enterococcus in a hematology unit. Am J Infect Control 2008;36:199205.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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