title: A study of the efficacy of flashing lights to increase the salience of alcohol-gel dispensers for improving hand hygiene compliance.
abstract: BACKGROUND
  Many interventions have been implemented to improve hand hygiene compliance, each with varying effects and monetary costs. Although some previous studies have addressed the issue of conspicuousness, we found only 1 study that considered improving hand hygiene by using flashing lights.
  
  
  METHODS
  Our attention theory-based hypothesis tested whether a simple red light flashing at 2-3 Hz affixed to the alcohol gel dispensers, within the main hospital entrance, would increase hand hygiene compliance over the baseline rate. Baseline and intervention observations were completed over five 60-minute periods (Monday-Friday) from 7:30 to 8:30 AM using a covert observation method.
  
  
  RESULTS
  Baseline hand hygiene compliance was 12.4%. Our intervention increased compliance to 23.5% during cold weather and 27.1% during warm weather. Overall, our pooled compliance rate increased to 25.3% (P < .0001).
  
  
  CONCLUSIONS
  A simple, inexpensive flashing red light affixed to alcohol gel dispensers was sufficiently salient to approximately double overall hand hygiene compliance within the main hospital entrance. We hypothesize that our intervention drew attention to the dispensers, which then reminded employees and visitors alike to wash their hands. Compliance was worse during cold days, presumably related to more individuals wearing gloves.
authors: Department of Medicine, University of Ottawa, Ottawa, ON, Canada. Electronic address: degidio.gianni@gmail.com.
authors: Gianni
authors: G
authors: D'Egidio
authors: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors: Rakesh
authors: R
authors: Patel
authors: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors: Babak
authors: B
authors: Rashidi
authors: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors: Marlene
authors: M
authors: Mansour
authors: Ottawa Research Health Institute, University of Ottawa, Ottawa, ON, Canada.
authors: Elham
authors: E
authors: Sabri
authors: Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada.
authors: Paul
authors: P
authors: Milgram
mesh_terms: D000438:Alcohols / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods; D004202:Disinfectants / Q000627:therapeutic use*; D004203:Disinfection / Q000706:statistics & numerical data*; D005782:Gels / Q000627:therapeutic use*; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006801:Humans
chemical_list: D000438:Alcohols; D004202:Disinfectants; D005782:Gels
keywords: Flashing lights; Hand hygiene; Human factors; Infection control