By Design September 2014

Better Hygiene Through Humiliation

A device that reminds doctors and nurses to wash their hands
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Gregory Reid

As doctors and nurses move through hospitals, they aren’t the only ones making rounds—hitching a ride on their hands are dangerous bacteria that can lead to infections ranging from antibiotic-resistant staph to norovirus. According to the Centers for Disease Control and Prevention, health-care-related infections affected nearly 650,000 Americans and led to about 75,000 deaths in 2011 alone. Clean hands would have helped prevent many of them. Yet studies show that, on average, fewer than half of health-care workers clean their hands as often as they should.

In recent years, a number of companies have designed systems that aim to nudge doctors and nurses into washing their hands regularly. One of these devices, a badge made by Biovigil, aims to exploit a very powerful emotion: shame. When a doctor enters an exam room, the badge chirps and a light on it turns yellow—a reminder to the doctor as well as an alert to the patient that he is about to be touched by someone with unclean hands. If the doctor doesn’t wash her hands, the light flashes red and the badge makes a disapproving noise. After the doctor waves a freshly sanitized hand in front of the badge, alcohol vapors trigger a sensor that changes the light from red to green. Other systems include HyGreen, which also uses badges; Hyginex, a wristband that can tell when a user dispenses hand sanitizer (and vibrates if he or she doesn’t); and SwipeSense, which includes a hand-sanitizer dispenser that clips onto scrubs.

Each of these devices generates a log that’s uploaded to a database of what HyGreen calls “all hand hygiene events in the hospital”—a rundown of who’s washing up, and who isn’t. The data could help hospitals engage in after-the-fact analysis of how an outbreak occurred, and, with any luck, might help them to prevent the next one.

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Eleanor Smith is an Atlantic senior associate editor.

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