Toronto Rehab scientists develop hand hygiene system to help healthcare professionals fight the spread of superbugs in Canadian hospitals

    TORONTO, March 3 /CNW/ - Each year in Canada about 8,000 patients - or
approximately 22 people a day - die from hospital-acquired infections. It is
estimated that as many as half of these deaths are attributable to inadequate
hand cleansing on the part of health-care workers. Researchers at the Toronto
Rehabilitation Institute (Toronto Rehab) are developing state-of-the-art
technology that will help professional caregivers to reduce hospital-acquired
infection rates and provide safer patient care.
    "Blaming the spread of infections in hospitals on health-care workers is
not really fair," says Dr. Geoff Fernie, Toronto Rehab's Vice President of
Research. "Healthcare professionals typically work in very busy clinical
environments with multiple competing demands for their time and attention. It
is very difficult for them to remember to clean their hands each and every
time they have contact with a patient."
    While everyone can improve their hygiene habits, according to Dr. Fernie,
a health-care worker would need to disinfect his/her hands 100 to 150 times
per eight hour shift to achieve 100 per cent compliance. That is approximately
once every five minutes and, during especially busy times, the need to
disinfect could be as high as 70 times per hour. That works out to the
equivalent of once per minute.
    "We need to help caregivers remember to cleanse their hands at critical
junctures in their daily care routine," adds Dr. Fernie. "Our new hand hygiene
technology will help healthcare professionals improve the consistency of their
hand cleansing practices and support them in maintaining a safe and healthy
environment for their patients and themselves."
    All workers in patient care environments would be outfitted with a small
sensor attached to their identification lanyard. This sensor is part of an
overhead electronic monitoring system that reminds healthcare staff by way of
an auditory signal (a beep) to cleanse their hands, if they have not already
done so, when they approach or leave different patients. A portable alcohol
gel dispenser that is attached to their waist or a static alcohol gel
dispenser mounted to a wall - both equipped with sensors - can detect whether
or not hands have been washed prior to and after individual patient/caregiver
contact. The system also records the time of entry and exit of each designated
patient area and the number of times hands are disinfected to obtain an
overall record of hand cleansing compliance.
    "A sink located in a patient room or elsewhere on the unit is not always
convenient to get to between patients especially on very busy shifts. A
wearable unit that is equipped with an alcohol gel dispenser and sensors that
remind you to cleanse your hands is a convenient and more effective way to
ensure that you adequately disinfect your hands before attending to your
patient," says Veronique Boscart, a Toronto Rehab nurse and researcher who
worked on the system's first pilot study. "When you are busy, disinfecting
your hands every time you have contact with a new patient is very difficult to
sustain over time."
    A few hospitals in Europe and the United States have implemented
successful hand hygiene programs reporting increases in hand cleansing
frequency and decreases in certain types of hospital infections, however,
achieving better staff hand hygiene practices does not happen overnight and is
difficult to sustain.
    "A cultural change needs to take place so that cleaning your hands when
you walk into a patient's room will be the norm," says Dr. Allison McGeer,
Director of Infection Control at Mount Sinai Hospital who is on the team
developing the system. "Changing behaviour to establish this new culture will
take time. This hand hygiene system is an effective tool to help health-care
workers achieve better hand hygiene now."
    "There are many factors that influence the development of
hospital-acquired infections. While it is well established that the most
effective way to stop the spread of infections in hospitals is hand hygiene
using an alcohol hand gel, good hand hygiene must be used in combination with
other measures such as better hospital design, adequate cleaning and
disinfection of the hospital environment and medical equipment, effective use
of aseptic technique and appropriate use of personal protection gear such as
masks, gowns, gloves, and face shields, and optimal antibiotic management,"
says Dr. McGeer.
    Under proposed new standards for infection prevention and control
developed by the Canadian Council on Health Services Accreditation in March
2007, hospitals will be required to monitor infection rates and participate in
hand hygiene initiatives to maintain their accreditation. The Ontario Ministry
of Health and Long-Term Care is also concerned about hospital-acquired
infections. Between December 2006 and August 2007, the Ministry tested a new
hand hygiene improvement program called Just Clean Your Hands in 10 Ontario
hospitals. Among the various results compiled from health-care worker and
patient surveys and observational auditor comments, the study found that when
cleaning their hands, 75 per cent of health-care workers were more likely to
use an alcohol based hand sanitizer than soap and water. Given the urgent need
to significantly reduce mortality rates caused by hospital-acquired
infections, Dr. Fernie anticipates that demand for the new hand hygiene system
will be considerable.
    "We've been successful in obtaining the research funding required to get
us to this stage in the development process. What we need now is significant
investment to accelerate development, refine the product and get it into the
hands of those who are in a position to save thousands of lives each year,"
says Dr. Fernie.
    Dr. Fernie predicts that the system will be on the market in the next two

    Toronto Rehabilitation Institute (Toronto Rehab) is at the forefront of
one of the most important and emerging frontiers in health care today -
rehabilitation science. Toronto Rehab is one of Canada's leading academic
rehabilitation science centres providing adult rehabilitation services,
complex continuing care, and long-term care. More information is available at:

For further information:

For further information: Carolyn Lovas, Media Relations Specialist,
Toronto Rehab, (416) 597-3422, ext. 3837,

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