Field of the Invention

The present invention relates to a system, apparatus and method for enabling maintenance of hand hygiene. In particular, but not necessarily restricted thereto, the present invention relates to the prevention of the spread of infection, especially in hospitals and like institutions.

Background to the Invention

Infections that are acquired in hospital are known, not surprisingly, as hospital acquired infections, or HAIs, and are responsible in the United Kingdom for several thousands of deaths annually. The situation is similar in other countries; it is not unusual for ten percent or more of patients in hospital acquiring a new infection during their stay.

Such nosocomial infections increase the burden on healthcare systems. It is believed that fifty per cent of nosocomial infection arise, at least in part due to poor hand hygiene issues. It is accepted that simple handwashing routines can inhibit significantly the transfer of pathogens present on the skin of doctors and nurses.

Methicillin-resistant Staphylococcus aureas (MRSA) is a strain of the Staphylococcus aureas bacterium that has developed resistance to antibiotics. It has a high morbidity, and is a problem in hospitals, where it can spread rapidly. Hospital wards address MRSA by the provision of alcohol-based hand rub dispensing units which are placed in wards, typically in foyers and thoroughfares within wards - alcohol has been shown to be effective against the bacterium. Whilst hand hygiene (HH) - comprising the rubbing of hands with an alcohol-based solution at precise moments during patient care is seen as an important factor in preventing healthcare associated infections. Even after years of HH advocacy, however, HH compliance remains substandard throughout the majority of healthcare scenarios. Whilst it is known that alcohol-based hand rubs are not effective in all situations, the dispensed product and/or cleaning procedure can be changed in the event that a different disease is prevalent in a particular location.

Within food factories there will also be cleanliness standards to be maintained. Visitors to sites, akin to visitors to hospitals will need to keep their hands clean. Similarly, maintenance staff in hospitals, food production facilities and similar premises will need to monitor both visitors and members of staff, who ordinarily are not automatically minded to clean their hands, to do so.

In GB 2446871 M. Braddock provides a method for assisting the use of a hygiene procedure, e.g. hand-washing, the method including the restriction of movement of personnel by detecting a condition indicating that a hygiene procedure has not been carried out, or by not detecting a condition indicating that a hygiene procedure has been carried out, and actuating a movement restricting condition accordingly. The movement restriction may comprise the locking, or failing to unlock, of an exit. Detection of use of hygiene equipment may be sent to an ID card, preferably containing RFID technology, held by the user which may then be used to grant the user unrestricted movement, i.e. to unlock the exit. To promote further hygiene, the ID card may contain an antibacterial agent. The locking mechanism may also comprise an artificial 'nose', wherein the door is unlocked if a tracer agent added to the handwash is detected on a users hands. This system suffers from complexity and only provides checking in relation to specific lockable areas. Difficulties will arise in emergency access.

WO 2008119158 to GC Hufton et al teaches a system and method of encouraging compliance of hand hygiene in an environment where users move from zone to zone and are required to perform hand hygiene between the zones. Users carry a wearable zone sensor which detects zones, detects hand hygiene actions, logs time of changing zones, and hand hygiene actions. The wearable sensor can be integral with a wearable hand hygiene product dispenser and/ or can operate in cooperation with a fixed dispenser configured to transmit hand hygiene actions to the wearable zone sensor. The wearable zone sensors are configured to be useable anonymously or to be associated with a user identifier, and to interface with a central computer via a docking station or communication interface to transfer data for later analysis. This system is of enormous complexity and still does not address many basic issues; the system is zoned to a ward extent and is not patient specific.

Another problem infection is Clostridium difficile or C-diff, which is resistant to many antibiotics and which can become a problem during treatment using antibiotics for other ailments, since the bacteria that ordinarily keep c-diff under control are not present. It is spread by the fecal-oral route and infection is controlled by routine hygiene, including, importantly, hand washing. Hygiene activity is currently monitored by means of visual observation and recording and manual logging of the event. Some smaller scale electronic systems also exist, but these have not been widely accepted nor adopted.

Object to the Invention

The present invention seeks to provide an improved hygiene monitoring system.

The present invention seeks to provide an improved hygiene system which overcomes at least some of the problems that have become apparent with regard to known systems. The present invention also seeks to provide a method for monitoring hand hygiene and also improved devices and equipment for monitoring hand hygiene.

Summary of the Invention

In accordance with a first aspect of the invention, there is provided a hygiene monitor system, for placement within a site where specific hand hygiene rules apply, the system comprising a hand cleansing dispenser station including a hand cleansing dispenser, a clock and a label printer; wherein each dispenser station includes an activation sensor operable to determine when an amount of hand cleanser has been dispensed wherein the printer will then print out a label with reference to a time of cleaning, to be attached to said specific user whereby it can be visually indicated that said specific user has performed a cleansing operation.

Conveniently the printer will automatically print out the label, for example by having a cleanser activation detector which enables the printer to print a label which either indicates one of or more of the time of cleaning, the time the hand cleaning process should be repeated / the person should no longer be present in a particular area or a period of time in which one should consider approaching a hand cleaning dispenser station / one should consider leaving an area where hand hygiene controls exist. In the alternative, the person will instruct the printer to print a label upon activation of the dispenser of the hand cleaner compound, for example by pressing a button or, more conveniently, by operating a light sensor switch or other non-contact switch mechanism.

Thus, the present invention provides a simple to use and simple to enforce method of determining whether or not a person of a specific class, e.g. a visitor, institutional personnel, etc, has washed their hands or not. In accordance with another aspect of the invention, there are provided FID tags, which RFID tags are operably worn by specific users to said site, wherein each dispenser station includes an RFID sensor operable to detect the presence of one of said specific users wherein the printer will then print out a label with an identification of the person identified by the RFID tag, to be attached to said specific user, whereby it can be visually indicated that said specific user has performed a cleansing operation.

The specific user may be a visitor to a premises; normal staff such as a ordinary health care worker within a health care institution, for example, may wear an RFID device, but not cause a printer to print a label, since they are normally in contact with patients etc., are aware of the implications of hand hygiene and, for example, clean their hands far more often then a minimum time prescribed by the labels.

In the alternative, the label is printed upon request, by operation of a trigger associated with further movement of a person within a particular premises. Alternatively a positive action from the personnel could indicate a hand wash completion, for example the continued depression of a foot lever, which could also cause the printer to operate.

It will be appreciated that the invention can be modified in a number of ways. For example, the indicator could be accompanied by a colour change in an ink; a message becomes increasingly visible over a period of time / becomes a different colour / becomes non-visible i.e. a message disappears after a pre-determined period of time. Messages such as ^tt I have clean hands." Or "My hands are dirty." Could fade / become increasingly visible over a period of time. The period of time could be varied; in a first example, the period set for ostensibly clean hands could be 20 minutes in a paediatric ward; 30 minutes in a labour ward etc. The label may conveniently be attached to a device comprising an RFID tag. The label and or RFID tag my bear an indication of the person assigned to wear the tag.

The system, in a basic arrangement, assumes or considers that a second, clean state of hygiene is achieved upon the identity tag remaining within a particular area associated with the hand hygiene wash for a pre-determined time.

In a hospital scenario, for example, a visitor, upon entry would be provided with an RFID tag. Upon approaching an area of pre- determined cleanliness, the visitor would approach a hand cleansing station, apply the hand cleansing liquid or compound, the station would recognise the presence of the visitor and, preferably automatically, the printer would print a label indicating that the visitor presently has hand clean hands. The time of cleansing may be indicated; the message may become opaque or invisible after the expiry of a predetermined period of time.

Other persons working within the institution may perform visual checks in addition to the wearer of the label.

Similarly, in a food processing factory, a visitor may be subject to specific monitoring issues; before entry to a working zone, then a hand hygiene procedure must be followed. This hand hygiene procedure may need to be repeated after a period of time; the procedure may need to be performed upon exit from a production area.

In accordance with a further aspect of the invention, there is provided a system, including a reception station which includes a camera operable to take photographs of the visitor which may then be attached to a tag for use by visitors, with the tag making it clear to other personnel that the visitor may well need assistance in approaching patient areas and that care would need to be taken with respect to touching objects etcetera and that attention is drawn to a label with a time indication. The label may include a photograph of the person wearing the label, for added security.

A system, according to the present invention, enables hygiene compliance in a specific zone within a facility to be evaluated and can cover the whole of a facility. RFID systems can also be incorporated in a system in accordance with the present invention; RFID detectors can be connected to a monitoring network. In contrast to general hygiene maintenance within a ward or similar, the present invention provides a system for encouraging the regular cleansing of hands, upon entry to and exit from a zone where particular hygiene levels must be maintained, for example a patient zone. As will be appreciated, the present invention is applicable to any scenario where there will be visitors and a need for hand hygiene to be maintained, such as a food processing factory, a hospital, a care home and the like.

Brief Description of the Drawings

Embodiments of the invention will now be described, by way of example only, with reference to the drawings, in which :

Figure la is a side elevation view of a person at a hand hygiene station in accordance with a first aspect of the present invention;

Figure lb is a side elevation view of a person at a hand hygiene station in accordance with a second aspect of the present invention;

Figure 2 show a label in accordance with the invention; and

Figures 3a and 3b each comprise a flow chart of a process in accordance with the invention.

Detailed Description of the Preferred Embodiments

There will now be described, by way of example only, the best mode contemplated by the inventor for carrying out the present invention. In the following description, numerous specific details are set out in order to provide a complete understanding to the present invention. It will be apparent to those skilled in the art, that the present invention may be put into practice with variations of the specific.

Figure la depicts a first example of the invention with regard to a patient care facility, for example, in a hospital. An outline view is shown of a person 11 approaching a hand cleaning station 14. The hand cleaning station includes a hand wash device 15, which conveniently comprise an alcohol gel dispenser, which dispensers have been found to provide a simple to apply compound which provides sufficiently cleaning strength to kill bacteria known to populate the type of premises where the hand cleaning station is situated. The person is shown with their hands below an outlet of the dispenser. Other dispensers are known which do not comprise a gel dispenser.

The gel dispenser is equipped with a trigger movement sensor 17 whereby the system can determine when the pump trigger has been activated to a sufficient degree to provide a sufficient amount of cleaning gel which is deemed to be sufficient to remove all hazardous bacteria resident upon the typical hand, if used properly. The printer 16 associated with the hand cleaning station would print out a label indicating that at a particular time on a particular day, that the person wearing the label has cleaned their hands. The label is conveniently attached either to, for example, their lapel or other part of the clothing or body that the person had cleaned their hands.

Conveniently, the label can provide a visual indication of expiry of the state of cleanliness, by way of a time stamp; additionally there is an indication that the time - for which a safe period before requiring a further washing of the hands is still valid or has expired - is visible to the person wearing the label and/or other parties who may politely remind the wearer of the label that a visit to a wash station is required. Whilst it is appreciated that a visitor will not normally be mindful of the passage of time and a requirement to visit a hand hygiene station to maintain a level of cleanliness, a visual indication can act as a prompt to those in visual contact with the visitor, especially, for patients who are being visited, health care workers or those who normally work in a particular facility. The term healthcare worker is to be understood as to be any personnel associated with any degree of patient contact, i.e. doctors, nurses, porters, cleaners etc. Equally, in other non-healthcare environments, all personnel in a workplace are to be treated as equally susceptible of transferring possible sources of infection .

Figure lb depicts a second example of the invention with regard to a patient care facility, for example, in a hospital. An outline view is shown of a person 11 wearing an RFID badge 12 approaching a hand cleaning station 14. The hand cleaning station includes a hand wash device 15 and basin, 18, the hand wash device being equipped with a trigger movement sensor 17 whereby the system can determine when the pump trigger has been activated to a sufficient degree, whereby hands can be treated with sufficient hand washing compound deemed sufficient to remove all hazardous bacteria resident upon the typical hand, if used properly. In the presence of an RFID badge, of a visitor or other type of personnel not normally utilising such premises, then the printer 16 associated with the hand cleaning station would print out a label indicating that at a particular time, on a particular day that the person who would affix the label either to their RFID badge or a lapel or other part of the body or clothing that the person had cleaned their hands.

Conveniently, the label can provide a visual indication of expiry of the state of cleanliness, by way of a time stamp; additionally there is an indication that the time - for which a safe period before requiring a further washing of the hands is still valid or has expired - is visible to the person wearing the label and/or other parties who may politely remind the wearer of the label that a visit to a wash station is required.

Whilst it is appreciated that a visitor will not normally be mindful of the passage of time and a requirement to visit a hand hygiene station to maintain a level of cleanliness, a visual indication can act as a prompt to those in visual contact with the visitor, especially health care workers or those who normally work in such a facility. The term healthcare worker is to be understood as to be any personnel associated with any degree of patient contact, i.e. Doctors, nurses, porters, cleaners etc. Equally, in other non-healthcare environments, all personnel in a workplace are to be treated as equally susceptible of transferring possible sources of infection.

Figure 2, shows a front face of a label 15 as to be worn by a visitor. The front face 21 has preferably two zones 22, 23, the first one of which confirm the name of the wearer, preferably with a photograph and a particular status, the second zone providing date and/or time information relevant to the task in hand. For example, international colour codes of green for safe (i.e. recently washed hands) and red for un-safe (i.e. unclean hands) could be indicated by the use of inks that change colour over time. Alternatively, a message such as "I HAVE CLEANED MY HANDS" may be replaced by a term such as "EXPIRED" over a period of time. The use of inks to determine this is known; the periods of use can vary from several minutes to a couple of hours or more. Means may be provided to enable the label to be arranged on a tag for example whereby it may be pinned to a collar, jacket or otherwise be displayed, or otherwise such as to be hung on a chain, but concerns regarding visibility for certain wireless transmissions may limit the use of certain types of attachment. The label may comprise an adhesive backed substrate. The adhesive is conveniently of a type which is resistant to or complimentary with the dispensing cleaner whereby the adhesion of the label is not compromised by a tacky hand (with cleaning fluid) does not compromise any subsequent attachment of the label upon another surface. Where there is a particular confinement of personnel, for example, a clean hands only area, then the label must be removed the instant the visitor leaves the designated clean hands area, and the visitor can only re-enter the clean hands area when he / she have re used the alcohol gel.

It is possible to have the time-temperature indicator to be arranged such that an audible buzzer is activated by the use of a conductive time-temperature indicating liquid.

To enable a greater understanding of the present invention, reference shall now be made to Figure 3a, which comprises a flow chart, which tracks the stages, in relation to hand hygiene, associated with a visitor at a hospital who has come to visit a particular patient.

In the first stage, and with specific reference to stage 1, a visitor enters a hospital building, via the route allowed for visitors and approaches a wash station (Stage 2).

Once at the hand hygiene station, the visitor applies the cleansing compound, conveniently comprising a gel; a printer prints out a label, identifying the time of cleaning/ time to be cleaned again etc. (Stage 3).

With reference to Figure 3b, there is shown a flow chart, which tracks the stages, in relation to hand hygiene, associated with a visitor at a hospital who has come to visit a particular patient.

In the first stage, and with specific reference to stage 1, a visitor enters a hospital building, via the route allowed for visitors and approaches an entrance desk where the visitor is identified and provided with an RFID identity tag. If no image of the visitor is on record in the system, then, conveniently employing a digital camera, an image is taken of the visitor, once apprised of the hand hygiene rules relevant to a particular ward. Directions to a particular ward are given, if necessary, and the visitor is told to proceed to an adjacent hand hygiene cleansing station. In the second stage, the visitor equipped with an RFID tag approaches the wash station (Stage 2).

Once at the hand hygiene station, the RFID device communicates with the equipment and the visitor applies the cleansing compound, conveniently comprising a gel; a printer prints out a label, identifying the person which also includes a photograph of the visitor. A date stamp is provided (Stage 3) .

In either of the two stages indicated above, the visitor would then have a label which indicates that they have hands that are deemed clean up until the expiry time, as indicated upon the label, by which time the visitor may well have left the premises or otherwise, the visitor ought to visit a hand hygiene station again. The duration of the safe period is determined upon a number of factors including the type of hand cleaner, the nature of the visitor's duties, any prevalence of disease and other factors (Stage 4). The visitor would be advised to approach a further cleansing station after, for example, sneezing.

It is to be understood that a number of hand hygiene apparatus will be distributed around a hospital, for all to use. It is assumed that typical healthcare workers will be accustomed to a regular cleaning routine and their use will not activate a printer, due for example to the HCW either not having an RFID or because the HCW's RFID does not activate the printer.

Each hand hygiene station may have the same hand hygiene gel/liquid/cream dispensed through the apparatus. Typically, this will be an alcohol gel, although a specific hand wash solution may be appropriate for specific wards. The system may deem a person to be cleaned by virtue of having pressed a trigger or tap. However, for example when an outbreak of a particular disease has occurred, a more stringent regime may be required; for example, a clean hands label may not be printed and dispensed unless a predetermined number of seconds of the RFID tag having been present after a depression of the plunger or other trigger. By spending a specific period of time before the hand hygiene apparatus can be sufficient for the controller to assume that a hand hygiene operation has been completed. A specific control device could be provided in the alternative, to particularly indicate that use of a cleansing compound had been made.

Thus in accordance with the first aspect of the invention, there is provided a point of care hand management system for use in healthcare facilities and the like.

Importantly, in health care institutions the present invention can also provide a method of monitoring personnel movement, to the extent they are fitted with an RFID tag.

Whilst it is appreciated in all healthcare facilities that visitors, although likely to assist in the recovery of patients from a psychological point of view, will assist in the introduction and transfer of pathogens etc.. Accordingly, the present invention also provides a system whereby visitors to a hospital etc. can have temporary identity tags provided, which can display their name, have a digital photograph taken whereby their hand hygiene can be monitored. Accordingly, in accordance with a further aspect of the invention, there is provided a reception station which includes a camera operable to take photographs of the visitor which may then be attached to a tag for use by visitors, with the tag making it clear to other personnel that the visitor may well need assistance in approaching patient areas and that care would need to be taken with respect to touching objects etc..

Turning now to other applications, a food processing line may be subject to particular contact controls. Whilst permissible levels of bacteria count in food processing manufacturers exist, all processing must be maintained below such levels. In order to maintain high levels of satisfactory cleanliness, the present invention can assist in meeting such standards. Particularly, the present invention can provide tags for use by cleaners, manufacture process workers and supervisory staff. Whilst all staff will know that they should achieve and maintain levels of hygiene, it will be appreciated that certain food manufacturing process agents will provide nutrients for bacteria, insects and vermin in general. By the provision of tags which can provide visual reminders of the need to maintain cleanliness before entering a food preparation zone and, importantly to wash off debris, in particular food debris after contact therewith standards of hygiene can be drastically be improved. Importantly, the tags will provide an auto-stimulus; personnel using such tags will want to maintain a level of hygiene prior to, for example, time expiry of a safe level of hand hygiene. By the provision of tags colour-based indications of cleanliness can be readily identified by other personnel.

Importantly, in health care institutions, food manufacturing facilities and the like, the present invention provides a method of visually inspecting personnel who are obliged to apply a treatment within a period of time, to enable passage within a building. Whilst an image taken by a camera can be provided by a printer associated with a particular hand hygiene station, this is not necessary for basic implementations of the invention. Notwithstanding this, the system could be employed in, for example, an infection control team to assist in the determination of a likely cause of spread of an infection by the monitoring of personnel movement. All of the above activity can be recorded into a centrally located office which could then be provided to an Infection Control team in conjunction with a hygiene solution company. This information allows the Infection Control team to monitor, measure and control all hand hygiene activity, and react immediately to any potential outbreak of healthcare associated infections such as MRS A / C-diff.