Major articleAn automated hand hygiene training system improves hand hygiene technique but not compliance

•Poor hand hygiene technique has been linked to transmission of multi-drug resistant organisms in hospital.•Our trial of a self-directed automated learning system was attempted by the majority of clinicians from all departments in an Australian tertiary teaching hospital.•The system received positive evaluation feedback as a ward-based tool for medical education.•This educational tool was trialed by our clinicians' to test their hand hygiene technique but it did not alter the hospital-wide compliance rate.

IntroductionThe hand hygiene technique that the World Health Organization recommends for cleansing hands with soap and water or alcohol-based handrub consists of 7 poses. We used an automated training system to improve clinicians' hand hygiene technique and test whether this affected hospitalwide hand hygiene compliance.MethodsSeven hundred eighty-nine medical and nursing staff volunteered to participate in a self-directed training session using the automated training system. The proportion of successful first attempts was reported for each of the 7 poses. Hand hygiene compliance was collected according to the national requirement and rates for 2011-2014 were used to determine the effect of the training system on compliance.ResultsThe highest pass rate was for pose 1 (palm to palm) at 77% (606 out of 789), whereas pose 6 (clean thumbs) had the lowest pass rate at 27% (216 out of 789). One hundred volunteers provided feedback to 8 items related to satisfaction with the automated training system and most (86%) expressed a high degree of satisfaction and all reported that this method was time-efficient. There was no significant change in compliance rates after the introduction of the automated training system. Observed compliance during the posttraining period declined but increased to 82% in response to other strategies.ConclusionsTechnology for training clinicians in the 7 poses played an important education role but did not affect compliance rates.