Hospitals Test Hand-Washing Detectors

Researchers at the University of Florida have developed a system that could save thousands of lives every year just by insuring that health care workers pay more attention to washing their hands. The system will monitor every time every nurse or doctor or technician washes his or her hands.

"This isn't big brother," said Richard J. Melker, a professor of anesthesiology who developed the system with several colleagues. But it will make it possible for everybody in the hospital, including patients, to know if the person who is about to lift their frock has clean hands.

The technology, called HyGreen, is surprisingly simple and has been tested in the intensive care unit of the university's hospital for several months. A number of hospitals have lined up to purchase the system, Melker said in a telephone interview. It is being manufactured by Xhale Inc., a university spinoff.

The cornerstone of the technology is a sensor that will "sniff" the soap and waterless cleaners used by the staff, and literally give the green light for the care giver to approach the patient. The technology addresses a basic problem that has bedeviled just about everybody in the health care business for some time now: How do you make sure people are washing their hands?

Millions Contract Illnesses From Health Care Workers

According to the Centers for Disease Control and Prevention, about 250 persons die in the United States every day from infectious diseases they acquired while in a hospital. And about 2 million persons get very sick from diseases like MRSA, which is usually transmitted by physical contact with a health care worker or another patient.

Those numbers, according to the CDC, the World Health Organization and several other organizations, could be cut in half just by proper hand washing. But how do you make sure people are living up to the rules?

The ideal way to do that, according to a 232-page report issued recently by the Joint Commission on Accreditation of Health Care Organizations, is to be sure that every time a worker washes his or her hands, the act is "observed by someone who is invisible, 24 hours a day, seven days a week, 365 days a year."

Surveillance Can Be 'Resource Intensive'

The commission noted that such surveillance is too "resource intensive" to be practical, but it will require health care organizations to come up with some sort of monitoring plan by the first of next year.

Melker and his colleagues think their technology will be even more reliable than having an invisible person follow each worker around. It will supply real-time information about who is washing their hands, and how often, and it could alert a patient if the nurse who is drawing near has washed his or her hands within the past 60 seconds.

For the sake of brevity, lets limit this to Nurse Ratchet. She enters a wash station, usually within a few steps of her patient's bed. Just above the sink is a small device with a motion detector. She splashes soap, or a waterless sterilizer, on her hands and rubs them briskly beneath the device for a second or so. Soaps used in hospitals have alcohol, some of which vaporizes and is sucked into the device by a small fan.

And bingo, a light on her name tag turns green. She continues to wash her hands for the required 15 seconds (much longer if she works in the operating room) and then moves on to her patient. As she approaches the bed, her nametag triggers a green light over the bed, telling the patient and anyone else in the room that Nurse Ratchet is clean.

Tech Can Be Used 24 Hours a Day

At the same time the info is sent to a central data system, so anyone else who needs to know can also see that Nurse Ratchet is clean.

If, however, her cell phone rang just before she entered the patient's room, and she paused to talk and thus delayed her arrival by 60 seconds, she wouldn't get that green light. Instead, a vibrator in her nametag would "buzz" her three times.

"We initially had some sounds, but you are going to use this 24 hours a day, so you don't want cute little musical tunes going off every time you enter the room, day and night," Melker said.

The exact cost is not yet known, but Melker claims that if it costs $3,000 per bed, the entire system will pay for itself within six months. It's likely, he said, that it will be used first in areas where the problem is greatest, like intensive care, and later expanded to the rest of the hospital.

Diseases Acquired in Hospitals Cost Billions

Infectious diseases acquired in hospital settings result in costs of about $20 billion a year, according to the U.S. Department of Health and Human Services. Some estimates place that considerably higher, and the Center for Medicare and Medicaid Services ruled last year that it would no longer reimburse hospitals for the expense of treating the infections.

"And they cannot pass the cost along to the patient," Melker said, so hospitals are paying a great deal of attention to the problem.

Of course, it remains to be seen whether this is the right solution. Such a device does not require any kind of federal approval, so there is no data available on how well it works other than that supplied by the folks who hold the patent. But the alternative, Melker said, is "to have people walking around the hospital periodically checking to see if people are washing their hands."

That's not a real good solution to a problem that has been around for decades. Some people thought Ignaz Semmelweiss, a Hungarian physician, had gone over the edge when he suggested that if doctors washed their hands before moving from a cadaver to the maternity ward a lot of babies could be saved. That was more than 160 years ago.

It took a long time, but now just about everybody knows that clean hands are next to godliness, especially in a hospital where most people are already sick. But hospitals are sort of like war zones. Too much to do. Too little time to do it. Easy to forget to wash up.

Maybe Melker's team has found a way to give a green light to a technological solution.