Utility of an Image Analysis Method as a Handwashing Measurement Tool

Abstract

Hands are the most common mode of transmission of infection from bacteria and viruses. Washing hands with soap and water is the most effective method for decreasing transmission of infection; however, research suggests that children do not routinely wash their hands using methods that healthcare agencies have determined best practice. Researchers have evaluated various antecedent and consequent strategies to address appropriate handwashing in young children. More research is needed, however, regarding the efficacy and efficiency of teaching and measuring handwashing accuracy and quality in young children. One method for assessing handwashing quality is comparing pre- and post-handwashing levels of proxy contamination using image analysis software. Further evaluation of the correlation between handwashing accuracy and hand cleanliness using proxy contamination should be conducted to determine the validity of this analysis method. The purposes of the current study were to (a) conduct a retrospective data analysis from a series of studies with children on errors made during handwashing and handwashing quality using an index of hand cleanliness and (b) examine the utility of an image analysis method as a measurement tool for hand cleanliness. Overall results suggest that the most important components of handwashing for increasing hand cleanliness include use of soap, amount of vigor, scrubbing the tops and palms of hands, and duration of scrubbing.