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Assessment of an Aggregate-Level Hand Hygiene Monitoring Technology for Measuring Hand Hygiene Performance Among Healthcare Personnel

  • Heather M. Limper (a1) (a2), Lynn Slawsky (a3), Sylvia Garcia-Houchins (a3), Supriya Mehta (a2), Ronald C. Hershow (a2) and Emily Landon (a1) (a3)...



Despite significant advances in technological methods for hand hygiene surveillance, a lack of evidence prohibits comparison of systems to one another or against the current gold standard of direct observation.


To validate a hand hygiene monitoring technology (HHMT) designed to capture hand hygiene behaviors aggregated at the hospital-unit level (GOJO Industries, Akron, OH).


Our team followed a rigorous validation approach to assess the sensitivity and positive predictive value (PPV) of an HHMT. A planned path was first used to measure the accuracy of the system when purposefully activated by investigators. Next, behavioral validation was used to quantify accuracy of the system in capturing real-world behaviors.


During the planned path phase, investigators performed 4,872 unique events across 3 distinct hospital buildings varying in size and age since construction. Overall sensitivity across the medical center was 88.7% with a PPV of 99.2%. During the behavioral validation phase, trained direct observers recorded 5,539 unique events across 3 distinct hospital buildings. Overall sensitivity across the medical center was 92.7% and PPV was 84.4%.


Objective measures of sensitivity and PPV indicate the promise of the benefit of this and other HHMTs to capture basic behaviors associated with hand hygiene.

Infect Control Hosp Epidemiol 2017;38:348–352


Corresponding author

Address correspondence to Heather M. Limper, MPH, University of Chicago Medicine, Center for Healthcare Delivery Science and Innovation, 5841 South Maryland Ave Chicago, Illinois 60637 (


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Assessment of an Aggregate-Level Hand Hygiene Monitoring Technology for Measuring Hand Hygiene Performance Among Healthcare Personnel

  • Heather M. Limper (a1) (a2), Lynn Slawsky (a3), Sylvia Garcia-Houchins (a3), Supriya Mehta (a2), Ronald C. Hershow (a2) and Emily Landon (a1) (a3)...


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