{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T09:46:16Z","timestamp":1775382376521,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1170937"],"award-info":[{"award-number":["1170937"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2004316"],"award-info":[{"award-number":["2004316"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Syst"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The World Health Organization (WHO) recommends a six-step hand hygiene technique. Although multiple studies have reported that this technique yields inadequate skin coverage outcomes, they have relied on manual labeling that provided low-resolution estimations of skin coverage outcomes. We have developed a computational system to precisely quantify hand hygiene outcomes and provide high-resolution skin coverage visualizations, thereby improving hygiene techniques. We identified frequently untreated areas located at the dorsal side of the hands around the abductor digiti minimi and the first dorsal interosseous. We also estimated that excluding Steps 3, 6R, and 6L from the six-step hand hygiene technique leads to cumulative coverage loss of less than 1%, indicating the potential redundancy of these steps. Our study demonstrates that the six-step hand hygiene technique could be improved to reduce the untreated areas and remove potentially redundant steps. Furthermore, our system can be used to computationally validate new proposed techniques, and help optimise hand hygiene procedures.<\/jats:p>","DOI":"10.1007\/s10916-022-01817-z","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T11:10:37Z","timestamp":1651835437000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A System for Computational Assessment of Hand Hygiene Techniques"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8213-6582","authenticated-orcid":false,"given":"Chaofan","family":"Wang","sequence":"first","affiliation":[]},{"given":"Weiwei","family":"Jiang","sequence":"additional","affiliation":[]},{"given":"Kangning","family":"Yang","sequence":"additional","affiliation":[]},{"given":"Zhanna","family":"Sarsenbayeva","sequence":"additional","affiliation":[]},{"given":"Benjamin","family":"Tag","sequence":"additional","affiliation":[]},{"given":"Tilman","family":"Dingler","sequence":"additional","affiliation":[]},{"given":"Jorge","family":"Goncalves","sequence":"additional","affiliation":[]},{"given":"Vassilis","family":"Kostakos","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"1817_CR1","unstructured":"World Health Organization (WHO): WHO Guidelines on Hand Hygiene in Health Care, (2009)"},{"key":"1817_CR2","unstructured":"Taylor, L.J.: An evaluation of handwashing techniques-1. Nurs Times (1978a)"},{"key":"1817_CR3","unstructured":"Taylor, L.J.: An evaluation of handwashing techniques-2. Nurs Times (1978b)"},{"key":"1817_CR4","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.31.10.923","author":"GA Ayliffe","year":"1978","unstructured":"Ayliffe, G.A.J., Babb, J.R., Quoraishi, A.H.: A test for 'hygienic' handdisinfection. J Clin Pathol (1978).\u00a0https:\/\/doi.org\/10.1136\/jcp.31.10.923","journal-title":"J Clin Pathol"},{"key":"1817_CR5","unstructured":"Standardization, E.C.: European Standard, EN1500:2013, CHEMICAL DISINFECTANTS AND ANTISEPTICS. HYGIENIC HANDRUB. TEST METHOD AND REQUIREMENTS (PHASE 2\/STEP 2). Eur Comm Stand (2013)"},{"key":"1817_CR6","doi-asserted-by":"publisher","unstructured":"Durso, F.T., Parmar, S., Heidish, R.S., Tordoya Henckell, S., Oncul, O.S., Jacob, J.T.: Improving the communication of hand hygiene procedures: Controlled observation, redesign, and randomized group comparisons. Infect Control and Hospital Epidemiology (2021).\u00a0https:\/\/doi.org\/10.1017\/ice.2020.407","DOI":"10.1017\/ice.2020.407"},{"key":"1817_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-8-149","author":"G Kampf","year":"2008","unstructured":"Kampf, G., Reichel, M., Feil, Y., Eggerstedt, S., Kaulfers, P.M.: Infuence\u00a0of rub-in technique on required application time and hand coverage in\u00a0hygienic hand disinfection. BMC Infect Dis (2008).\u00a0https:\/\/doi.org\/10.1186\/1471-2334-8-149","journal-title":"BMC Infect Dis"},{"key":"1817_CR8","doi-asserted-by":"publisher","unstructured":"Tschudin-Sutter, S., Sepulcri, D., Dangel, M., Ulrich, A., Frei, R., Widmer, A.F.: Simplifying the World Health Organization Protocol: 3 Steps Versus 6 Steps for Performance of Hand Hygiene in a Cluster-randomized Trial. Clin Infect Dis (2019).\u00a0https:\/\/doi.org\/10.1093\/cid\/ciy948","DOI":"10.1093\/cid\/ciy948"},{"key":"1817_CR9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105866","author":"AJ Stewardson","year":"2014","unstructured":"Stewardson, A.J., Iten, A., Camus, V., Gayet-Ageron, A., Caulfield, D.,\u00a0Lacey, G., Pittet, D.: Efficacy of a new educational tool to improve\u00a0handrubbing technique amongst healthcare workers: A controlled, before after\u00a0study. PLoS One (2014).\u00a0https:\/\/doi.org\/10.1371\/journal.pone.0105866","journal-title":"PLoS ONE"},{"key":"1817_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2014.12.002","author":"E Vanyolos","year":"2015","unstructured":"Vanyolos E, Peto K, Viszlai A, Miko I, Furka I, Nemeth N, Orosi P (2015) Usage of ultraviolet test method for monitoring the efficacy of surgical hand rub technique among medical students. J Surg Educ https:\/\/doi.org\/10.1016\/j.jsurg.2014.12.002","journal-title":"J Surg Educ"},{"key":"1817_CR11","doi-asserted-by":"publisher","unstructured":"Widmer, A.F., Conzelmann, M., Tomic, M., Frei, R., Stranden, A.M.: Introducing Alcohol-Based Hand Rub for Hand Hygiene The Critical Need for Training. Infect Control & Hospital Epidemiology 28(1), 50-54 (2007).\u00a0https:\/\/doi.org\/10.1086\/510788","DOI":"10.1086\/510788"},{"key":"1817_CR12","doi-asserted-by":"crossref","unstructured":"Lehotsky, A., Szilagyi, L., Bansaghi, S., Szeremy, P., Weber, G., Haidegger, T.: Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure. J Hosp Infect 97(1), 26-29 (2017).\u00a0https:\/\/doi.org\/10.1016\/j.jhin.2017.05.022","DOI":"10.1016\/j.jhin.2017.05.022"},{"key":"1817_CR13","unstructured":"World Health Organization (WHO): WHO: How to Handrub? With Alcohol-based Formulation.\u00a0https:\/\/www.youtube.com\/watch?v=ZnSjFr6J9HI.\u00a0Accesed 2019-12-06\u00a0"},{"key":"1817_CR14","doi-asserted-by":"publisher","DOI":"10.1109\/tsmc.1979.4310076","author":"N Otsu","year":"1979","unstructured":"Otsu. N.: THRESHOLD SELECTION METHOD FROM GRAY-LEVEL HISTOGRAMS. IEEE Trans Syst Man Cybern (1979).\u00a0https:\/\/doi.org\/10.1109\/tsmc.1979.4310076","journal-title":"IEEE Trans Syst Man Cybern"},{"key":"1817_CR15","unstructured":"Lugaresi, C., Tang, J., Nash, H., McClanahan, C., Uboweja, E., Hays, M., Zhang, F., Chang, C.L., Yong, M.G., Lee, J., Chang, W.T., Hua, W., Georg, M., Grundmann, M.: MediaPipe: framework for building perception pipelines (2019)"},{"key":"1817_CR16","doi-asserted-by":"publisher","unstructured":"Bradski G.: The OpenCV Library. Dr Dobbs J Softw Tools (2000).\u00a0https:\/\/doi.org\/10.1111\/0023-8333.50.s1.10","DOI":"10.1111\/0023-8333.50.s1.10"},{"key":"1817_CR17","doi-asserted-by":"publisher","DOI":"10.1136\/inpract.27.4.178","author":"S Gregory","year":"2005","unstructured":"Gregory, S.: How good is your hand hygiene? In Pract (2005).\u00a0https:\/\/doi.org\/10.1136\/inpract.27.4.178","journal-title":"In Pract"},{"key":"1817_CR18","doi-asserted-by":"publisher","DOI":"10.2196\/17001","author":"C Wang","year":"2020","unstructured":"Wang, C., Sarsenbayeva, Z., Chen, X., Dingler, T., Goncalves, J.,\u00a0Kostakos, V.: Accurate measurement of handwash quality using sensor\u00a0armbands: Instrument validation study. J Med Internet Res (2020).\u00a0https:\/\/doi.org\/10.2196\/17001","journal-title":"J Med Internet Res"}],"container-title":["Journal of Medical Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-022-01817-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10916-022-01817-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-022-01817-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T06:08:04Z","timestamp":1652940484000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10916-022-01817-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,6]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["1817"],"URL":"https:\/\/doi.org\/10.1007\/s10916-022-01817-z","relation":{},"ISSN":["1573-689X"],"issn-type":[{"value":"1573-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,6]]},"assertion":[{"value":"19 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 May 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}}],"article-number":"36"}}