SBIR-STTR Award

The objective of the proposed research is to develop and demonstrate Random Hand Hygiene Prompts (RHHP). RHHP will deliver voice messages at random times on a hospital floor, reminding listeners to perform hand hygiene. Preliminary results suggest that listeners, who include nurses, physicians, visitors and patients themselves, respond to these messages by voluntarily increasing their hand hygiene. As a result, nosocomial infections will decrease, saving lives and money. The Phase I research will demonstrate RHHP in a hospital. RHHP hardware includes sensors to detect soap and gel use and a computer, which both collects and stores data from the sensors and generates voice messages over speakers on the hospital floor. The research will include a baseline phase, during which hand hygiene is recorded but no voice messages are played; and an intervention phase, during which hand hygiene is recorded as before and voice messages are played. "Hand hygiene compliance" is defined here as the number of soap and alcohol gel uses per patient day. We will claim that RHHP is feasible if hand hygiene compliance increases significantly, at the 5% level, from the baseline to the intervention phase. In Phase II we plan to install RHHP at one or more hospitals and test it for an extended time, to demonstrate a reduction in nosocomial infections. In Phase III we plant to commercialize RHHP in conjunction with our partner, Steris Corporation. This research will demonstrate that hospital workers and others can be encouraged to wash and sanitize their hands by means of automated voice messages. As a result of the work proposed here, hospital acquired infections, those acquired after admission, will be reduced because the link between one patient's infection and another's, via health care worker's hands, will be broken. Then the approximately 90,000 U.S. deaths per year, and other costs due to hospital acquired infections, will decrease as well. Random Hand Hygiene Prompts will encourage hand washing and hand sterilization in hospitals. It will affect public health by reducing the chance of a patient acquiring an infection in a hospital - a public place. RHHP has the potential to reduce the cost of hospital acquired infections by a billion dollars and a hundred thousand deaths per year in the United States.

Thesaurus Terms:
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The long-term objective of the work proposed here is to develop and demonstrate Random Hand Hygiene Prompts (RHHP). RHHP is a device that 1) plays computer generated voice messages over loudspeakers at a hospital nursing station and 2) records hand hygiene events with soap and with sanitizer there. RHHP's voice messages play at random times and encourage healthcare workers to perform good hand hygiene. Phase I showed that listeners respond by washing their hands more often when RHHP's voice messages play than in their absence. In Phase II we will install RHHP in several hospital Intensive Care Units, where we will combine the hospital's census and RHHP's hand hygiene events to calculate hand hygiene events per patient per day, the standard measure of hand hygiene compliance. We will also measure the hospital acquired infection (HAI) rate. We will compare the hand hygiene compliance and the HAI rate in a baseline phase, when no voice messages play, to those rates in an intervention phase, when voice messages play. We will demonstrate that not only does hand hygiene increase in the intervention phase, but that the hospital acquired infection rate decreases as well. The result will be significant savings in lives and financial costs to the hospital. Further, RHHP reduces HAIs without using antibiotics, so it contributes to public health by minimizing the development of antibiotic-resistant organisms. We will optimize RHHP's hardware, software, phase lengths and message delivery parameters in Phase II, and investigate several research topics that can only be considered with the help of RHHP's detailed hand hygiene compliance measurements. At the same time, our collaborator Renoir Group will help us offer a simple version of RHHP for sale to customers convinced of its value by our Phase I results. In Phase III our collaborator A.C.C. Systems, Inc. will help us manufacture and market a more sophisticated RHHP to hospital chains.

Public Health Relevance:
Random Hand Hygiene Prompts will reduce the hospital acquired infection rate in hospitals where its voice messages play. As a result, fewer hospital patients will be colonized with infections on discharge and fewer infections will arise in the general public. Random Hand Hygiene Prompts will also reduce hospitals dependence on antibiotics. Then fewer strains of antibiotic-resistant bacteria will emerge, making it possible to treat more infections in the public with antibiotics

Public Health Relevance Statement:
Narrative Random Hand Hygiene Prompts will reduce the hospital acquired infection rate in hospitals where its voice messages play. As a result, fewer hospital patients will be colonized with infections on discharge and fewer infections will arise in the general public. Random Hand Hygiene Prompts will also reduce hospitals dependence on antibiotics. Then fewer strains of antibiotic-resistant bacteria will emerge, making it possible to treat more infections in the public with antibiotics

Project Terms:
Academic Medical Centers; Acclimatization; Accounting; Antibiotic Resistance; Antibiotic-resistant organism; Antibiotics; Bacteria; base; Businesses; Categories; Censuses; Cities; commercial application; commercialization; Communication; Community Hospitals; computer generated; Computer software; Computers; cost; cost effective; cost effectiveness; Data; Dependence; design; Development; Devices; Effectiveness; Ensure; Event; falls; Financial cost; Frequencies (time pattern); General Population; Hand; Health care facility; Health Personnel; Hearing; Hospital Costs; Hospital Nursing; Hospital Units; Hospitals; Human Resources; Hygiene; improved; Income; Infection; innovation; Intensive Care Units; Intervention; Investments; Length; Life; Link; Manufacturer Name; Marketing; Measurement; Measures; meetings; metropolitan; New York; Nosocomial Infections; Nursing Homes; patient population; Patients; Patients' Rooms; Phase; Phase II Clinical Trials; Play; Population; prevent; programs; prototype; public health medicine (field); public health relevance; Radio; Reader; Records; Reporting; Research; Research Project Grants; Sales; Savings; sensor; shift work; Site; Soaps; Sorting - Cell Movement; standard measure; System; Telephone; Testing; Text; Time; Vendor; Voice; Work