Using Thermal Imaging to Measure Hand Hygiene Quality

OBJECTIVES Hand hygiene has long been promoted as the most effective way to prevent the transmission of infection. However, due to the low compliance and quality of hand hygiene reported in previous studies, constant monitoring of healthcare workers' hand hygiene compliance and quality is crucial. In this study, we investigate the feasibility of using a thermal camera together with an RGB camera to detect hand coverage of alcohol-based formulation, thereby monitoring handrub quality. METHODS We recruited 32 participants for this study. Participants were required to perform four types of handrubs to produce different hand coverage of alcohol-based formulation. After each task, participants' hands were photographed under a thermal camera and an RGB camera, while an ultraviolet (UV) test was used to provide the ground truth of hand coverage of alcohol-based formulation. Then, a U-Net was used to segment areas covered with alcohol-based formulations from thermal images, and the system performance was evaluated by comparing coverage differences between thermal images and UV images regarding accuracy and Dice coefficient. RESULTS The system yields promising results in terms of accuracy (93.5%) and Dice coefficient (87.1%) when observations take place 10 seconds after performing handrub. In addition, we also examine the system performance change over a 60-second observation period, and the accuracy and Dice coefficient still remain at about 92.4% and 85.7% when observation happens at the 60-second time point. CONCLUSIONS Given these encouraging results, thermal imaging shows its potential feasibility in providing accurate, constant, and systematic hand hygiene quality monitoring.