title: The influence of spatial configuration on the frequency of use of hand sanitizing stations in health care environments.
abstract: BACKGROUND
  The lack of user-friendly, accessible, and visible hand sanitizing stations (HSSs) in health care environments are significant factors affecting low hand hygiene compliance rates among caregivers.
  
  
  OBJECTIVE
  To determine whether the simulated parameters of visibility and global traffic flow score for an HSS can influence the frequency of use of that HSS.
  
  
  METHODS
  Space syntax was used to measure virtual simulation of spatial layouts of 3 units to provide quantitative visibility and global traffic flow scores for each HSS. The frequency of use of HSSs was measured for 2 weeks in 3 units in a community hospital through electronic tracking with self-developed motion sensors. Behavioral observations were also conducted during the same period to validate hand hygiene data obtained through electronic tracking. Linear models were used to tests how much variance in use is accounted for when visibility and/or global traffic flow are included in the model.
  
  
  RESULTS
  When the visibility score for an HSS increases (decrease), frequency of use of the HSS will increase (decrease) (F [5, 65] = 13.877; P < .001). When the global traffic flow score for an HSS increases (decrease), frequency of use of the HSS will increase (decrease) (F [5, 65] = 13.877; P < .001).
  
  
  CONCLUSIONS
  This study proposed and validated a novel approach of using space syntax simulations to predict and optimize hand hygiene behavior.
authors.affiliation: Design and Environmental Analysis, Cornell University, Ithaca, NY. Electronic address: jn458@cornell.edu.
authors.forename: Jun Rong Jeffrey
authors.initials: JRJ
authors.lastname: Neo
authors.affiliation: Design and Environmental Analysis, Cornell University, Ithaca, NY.
authors.forename: Rana
authors.initials: R
authors.lastname: Sagha-Zadeh
mesh_terms: D003198:Computer Simulation; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods / Q000592:standards*; D006268:Health Facilities / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000592:standards*; D000073276:Models, Spatial Interaction; D011446:Prospective Studies; D012044:Regression Analysis; D062206:Spatial Analysis
keywords: Hand hygiene; Health care quality; Health care-associated infection; Space syntax