title: Effectiveness of an extended period of flashing lights and strategic signage to increase the salience of alcohol-gel dispensers for improving hand hygiene compliance.
abstract: Multiple factors affect compliance with hand hygiene, including conspicuity of alcohol-gel dispensers. Previous studies have shown that flashing lights increase hand hygiene compliance; however, the durability of this effect has not been studied.
  
  
  
  We affixed flashing lights to hand sanitizer dispensers for a total of 6 weeks. Regression analysis was used to compare compliance rates between the beginning and end of the intervention. Our secondary objective was to determine whether compliance rates in cold weather could be improved by adding a sign separated in time and space from the dispensers.
  
  
  
  Flashing lights improved hand hygiene compliance from 11.8% to 20.7%, and this effect was unchanged over the 6-week study period. Fully charged lights resulted in a greater compliance increase. A preemptive sign did not have a significant effect on hand hygiene rates nor did absolute temperatures.
  
  
  
  Flashing lights are a simple, inexpensive way of improving hand hygiene. Brighter lights appear to have a greater effect; however, this must be balanced with annoyance in specific settings. Temperature did not have a significant effect; however, this may be because the relationship does not fit a linear model. Other interventions, such as signs, may need to be tailored specifically to individual hospital environments.
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada. Electronic address: babakrashidi@gmail.com.
authors.forename: Babak
authors.initials: B
authors.lastname: Rashidi
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Aimee
authors.initials: A
authors.lastname: Li
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Patel
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Irene E
authors.initials: IE
authors.lastname: Harmsen
authors.affiliation: Ottawa Research Health Institute, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Elham
authors.initials: E
authors.lastname: Sabri
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Kyeremanteng
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Gianni
authors.initials: G
authors.lastname: D'Egidio
mesh_terms: D000438:Alcohols / Q000008:administration & dosage*; D004202:Disinfectants / Q000008:administration & dosage*; D005782:Gels / Q000008:administration & dosage*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017010:Reminder Systems / Q000295:instrumentation*
chemical_list: D000438:Alcohols; D004202:Disinfectants; D005782:Gels
keywords: Infection control; flashing lights; hand hygiene; human factors