title: An automated hand hygiene training system improves hand hygiene technique but not compliance.
abstract: BACKGROUND
  The hand hygiene technique that the World Health Organization recommends for cleansing hands with soap and water or alcohol-based handrub consists of 7 poses. We used an automated training system to improve clinicians' hand hygiene technique and test whether this affected hospitalwide hand hygiene compliance.
  
  
  METHODS
  Seven hundred eighty-nine medical and nursing staff volunteered to participate in a self-directed training session using the automated training system. The proportion of successful first attempts was reported for each of the 7 poses. Hand hygiene compliance was collected according to the national requirement and rates for 2011-2014 were used to determine the effect of the training system on compliance.
  
  
  RESULTS
  The highest pass rate was for pose 1 (palm to palm) at 77% (606 out of 789), whereas pose 6 (clean thumbs) had the lowest pass rate at 27% (216 out of 789). One hundred volunteers provided feedback to 8 items related to satisfaction with the automated training system and most (86%) expressed a high degree of satisfaction and all reported that this method was time-efficient. There was no significant change in compliance rates after the introduction of the automated training system. Observed compliance during the posttraining period declined but increased to 82% in response to other strategies.
  
  
  CONCLUSIONS
  Technology for training clinicians in the 7 poses played an important education role but did not affect compliance rates.
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Yen Lee Angela
authors.initials: YL
authors.lastname: Kwok
authors.affiliation: Infection Prevention and Control Unit, Campbelltown and Camden Hospital, Sydney, New South Wales, Australia.
authors.forename: Michelle
authors.initials: M
authors.lastname: Callard
authors.affiliation: School of Public Health and Community Medicine, UNSW Medicine, UNSW Australia, Sydney, New South Wales, Australia. Electronic address: m.mclaws@unsw.edu.au.
authors.forename: Mary-Louise
authors.initials: ML
authors.lastname: McLaws
mesh_terms: D001331:Automation / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D019983:Guideline Adherence; D063373:Hand Hygiene / Q000379:methods*; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans
keywords: Cleansing technique; Compliance; Seven poses