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Toronto (Feb. 9, 2010) - A sophisticated hand hygiene prompting system developed at Toronto Rehab is moving forward into clinical trials, backed by a new grant from the Canadian Institutes of Health Research (CIHR).
This is the first time an "intelligent" hand hygiene prompting system has been tested with a large number of healthcare workers in a hospital setting. The $371,652 grant will allow the research team to install their technology on a 50-bed unit-and to see if it improves hand hygiene compliance.
"Conventional hand hygiene programs improve matters for a while, but eventually levels of hand hygiene drop off again," says Dr. Geoff Fernie, vice president, research, at Toronto Rehab. "That's why we're working on a sustainable solution to this recurrent problem."
A hand hygiene prompting system has the potential to prevent many of the unnecessary deaths that result from hospital-acquired infections. Every year in Canada, one in 10 patients will catch something in hospital, and roughly half of these infections are because someone did not wash their hands.
Toronto Rehab's electronic hand hygiene monitoring system was designed by control systems specialist Dr. Alex Levchenko. At the heart of the system is a "smart ID badge" with an infrared sensor which is clipped to the caregiver's pocket or worn on a lanyard around the neck. The sensor interacts with tiny infrared emitters mounted on the ceiling in the zones where hand hygiene monitoring is critical - such as patient beds, room entrances, dirty utility rooms and other areas where there is a high risk of infection.
When a healthcare worker enters or leaves one of these zones, and the person has forgotten to perform hand hygiene, the device vibrates or produces an audible prompt. If hand hygiene rules are followed, the device displays a green light.
The same device also maintains detailed data on hand hygiene habits. This data is downloaded, analyzed, and hand hygiene performance reports are generated so caregivers can see where there's room for improvement.
Results from pilot tests, conducted on a four-bedroom unit at Toronto Rehab's E.W. Bickle Centre for Complex Continuing Care, are encouraging. "The technology works, and we have seen significant changes in behaviour," says Dr. Fernie. "Staff are excited. As professionals, they want to do their jobs as well as possible, and the system helps them do that."
With the newly-announced CIHR funding, the Toronto Rehab team will be able to determine if their new system leads to sustainable improvements in hand hygiene compliance when tested on a whole 50-bed nursing unit at the Bickle Centre over an extended period of 12 months.
"This new approach could lead to a major breakthrough in our efforts to reduce hospital-acquired infections and prevent the spread of other infections and illnesses such as influenza," says Dr. Fernie, a bioengineer who is overseeing the project.
Also involved in the upcoming clinical trial are: Dr. Matthew Muller, infection control physician at St. Michael's Hospital in Toronto; Dr. Alison McGeer, Director of Infection Control at Mount Sinai Hospital in Toronto; Dr. Kevin Thorpe, a biostatistician at the University of Toronto; and Dr. Levchenko of Toronto Rehab.
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