A system for computational assessment of hand hygiene techniques

Chaofan Wang, Weiwei Jiang, Kangning Yang, Zhanna Sarsenbayeva, Benjamin Tag, Tilman Dingler, Jorge Goncalves, Vassilis Kostakos

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)


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.

Original languageEnglish
Article number36
Number of pages12
JournalJournal of Medical Systems
Issue number6
Publication statusPublished - Jun 2022
Externally publishedYes


  • hand hygiene
  • handrub
  • healthcare-associated infections
  • nosocomial infections
  • six-step hand hygiene technique

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