Electronic handwashing tool could curb superbug spread

Canadian-made technology may provide health-care workers with a convenient reminder to disinfect before they touch their patients, helping eradicate so-called superbugs from hospital settings.

Even though diligent hand hygiene is known to significantly cut hospital-acquired infections, studies show that health-care workers wash their hands before seeing a new patient only about 30 to 40 per cent of the time. Physicians on rounds are among the worst offenders.

Superbugs are posing an increasing threat. These include MRSA (methicillin-resistant Staphylococcus aureus) and Clostridium difficile as well as E. coli and strains of viral influenza.

Now, researchers at the Toronto Rehabilitation Institute have developed a hand hygiene device. It consists of a sensor worn around the neck, infrared lights above the patient's bed, and an alcohol gel dispenser attached to the waistband.

A health-care worker wears the sensor and a beep is triggered when the person approaches a patient's bed, reminding them to use the sanitizing gel. If the health-care worker has already done so, the beep will not sound.

The system also records the time of entry and exit from each patient area and the number of times hands are disinfected. This data can be downloaded into a computer so individual staff members can check their overall hand hygiene and compare it anonymously against their peers.

Toronto Rehab nurse Veronique Boscart said a couple of pumps means she has just prevented the transfer of bacteria from patient A to patient B.

"Often because there is such a high demand, I wouldn't disinfect my hands in between two patients," she told CBC News. "This system reminds me to do so."

Geoff Fernie, a bio-engineer at Toronto Rehab, said the system takes into account the realities of hospital life. Health-care workers often need to clean their hands as many as 150 times a day, he said, so remembering each time can be challenging. 

"This is not simply a problem of lazy people that will be solved with discipline or education," he said. "It's a problem that needs a different solution."

The Community and Hospital Infection Control Association of Canada estimates 8,000 Canadians die from hospital-acquired infections every year. This amounts to 22 people a day.

The device has been tested with a small number of nurses and doctors at Toronto Rehab and feedback has been positive. Fernie believes that eventually, patients will insist health-care workers wear the devices.

"I can't imagine that you're going to get away without this device or a device like it on every health-care worker in every hospital and every nursing home," he said.

Dr. Allison McGeer, a microbiologist and infectious disease consultant at Toronto's Mount Sinai Hospital, said the hope is that eventually, hand hygiene will become second nature.

"Eventually I won't need the reminder because the behaviour will get embedded. It's like putting your seatbelt on when you get in the car."

The estimated cost of setting up the device is $300 per bed. Fernie said he hopes further studies will show it's an investment that will save lives.

Over the next two years, two wards at the downtown Toronto hospital and two at Toronto Rehab will be designated as test sites. One ward in each institution will be equipped with the monitoring system, while the other will not.

At the end of the study, which will cost about $200,000, overall hand hygiene of the different wards will be compared.