Embedded System for Recording and Controlling Hand Hygiene in Healthcare Environments
Rafael Castro, Alexandre dos Santos Roque
TL;DR
The paper presents an ESP32-based embedded system for automated hand hygiene monitoring in hospitals, integrating infrared, ultrasonic, and RFID sensing with an educational 11-step HH protocol displayed at the point of care. It records bed-entry/exit events, HH opportunities, and completion rates, sending data to the Losant IoT platform for real-time visualization and audits. The approach addresses limitations of manual audits and Hawthorne bias, offering a portable, scalable solution that can be deployed across hospital units. A 3-hour real-world validation demonstrated system feasibility, with data indicating measurable HH activity and actionable insights for infection control, despite occasional connectivity challenges. The work lays groundwork for future enhancements, including machine learning-guided guidance, camera-based augmentation, platform customization, and offline data storage resilience.
Abstract
Nowadays, more effective control of hand hygiene (HH) by healthcare teams has become essential. HH control is crucial to prevent cross-contamination and healthcare-associated infections (HAI), according to Brazilian regulatory standards and WHO guidelines. The lack of widespread technology to measure acceptable hygiene rates within hospital environments leads to the practice of a manual sample audit reading, requiring more time for decision making. Thus, the present study addresses the lack of automation technologies for HH, aiming to record, measure, and provide data for internal audits in hospitals. This article introduces an embedded system for HH control and recording, comprising low-cost hardware architecture with IoT connectivity and online monitoring. Results with practical evaluation in a real hospital setting for 3 hours demonstrated the system's effectiveness in recording HH indices.