Improving Hand Hygiene Compliance With Red Flashing Lights

Dr. Gianni D'Egidio HBSc, MD, MEng Academic Division of Internal Medicine Ottawa Hospital, Interview with:
Dr. Gianni D’Egidio HBSc, MD, MEng
Academic Division of Internal Medicine
Ottawa Hospital, Canada

Medical Research: What are the main findings of the study?

Dr. D’Egidio: Baseline hand hygiene compliance at our main entrance in our study was 12.4%.  We believe one of the main reasons for such an appalling low compliance was that individuals were distracted.  Visitors entering are often preoccupied with acquiring information to help them navigate a large and confusing environment given the multitude of signs, lights, announcements and other people.  Also, the majority of individuals entering have objects occupying their hands; keys, hand-held devices, coffee mugs, and during cold weather, gloves.  All this together contributes to poor compliance at our front entrance.

We hypothesized that a conspicuous flashing red light at 3 Hz (3 flashed per second) attached to alcohol hand dispensers located at our front entrance would attract an individual’s attention and hopefully increase compliance.  We measured hand hygiene compliance for 1-week periods from 07:30-08:30 before and after the implementation of our flashing lights.  We found that compliance increased by more than double to 25.3% (p<0.0001).

Medical Research: Were any of the findings unexpected?

Dr. D’Egidio: Yes.  Interestingly, compliance was worse during cold weather months (23.5%) compared to warm weather months (27.1%).  This could be explained by individuals wearing gloves.

Medical Research: What should clinicians and patients take away from your report?

Dr. D’Egidio: We believe that flashing red lights draw attention to the alcohol dispensers and, by doing so, remind individuals to wash their hands.  The use of highly conspicuous flashing red lights does not require education or training. These lights can be rapidly and easily deployed and replaced, are inexpensive, and are immediately effective.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. D’Egidio: We are uncertain if the increase in compliance observed in our study would last over a longer time period (i.e. months).  The possibility exists that individuals may become accustomed to the lights and some may resent or find them annoying.  We plan on conducting a second study addressing the duration of effect of flashing lights and to see if appropriately placed signage instructing individuals to remove their gloves will increase compliance during winter months.


A study of the efficacy of flashing lights to increase the salience of alcohol-gel dispensers for improving hand hygiene compliance

D’Egidio, Gianni et al.

American Journal of Infection Control , Volume 42 , Issue 8 , 852 – 855

Last Updated on August 9, 2014 by Marie Benz MD FAAD