J Hosp Infect. 2014 Oct;88(2):84-8. doi: 10.1016/j.jhin.2014.06.014.

Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance.

Storey SJ1, FitzGerald G1, Moore G1, Knights E2, Atkinson S3, Smith S3, Freeman O4, Cryer P5, Wilson AP6.
  • 1Department of Microbiology and Virology, University College London Hospitals, London, UK.
  • 2Heart Hospital, University College London Hospitals, London, UK.
  • 3Institute for Occupational Ergonomics, Faculty of Engineering, University of Nottingham, Nottingham, UK.
  • 4HCAI Service Users Research Forum, Faculty of Health and Human Sciences, University of West London, Brentford, UK.
  • 5Intromed Ltd, Leicester, UK.
  • 6Department of Microbiology and Virology, University College London Hospitals, London, UK. Electronic address: peter.wilson@uclh.nhs.uk.



BACKGROUND: Hand hygiene compliance is traditionally monitored by visual methods that are open to bias and strictly limited in time and place. Automatic monitoring may be more effective for infection control as well as performance management.

AIM: To establish accuracy and acceptability of an automatic contact monitoring system for hand hygiene.

METHODS: Monitoring equipment was installed across 55 beds in three wards, and included modified identity badges, bedside furniture, sinks and alcohol gel dispensers. Badges were in near-skin contact (through uniform) and could detect alcohol vapour. All devices were linked by wi-fi. A traffic light system on the badge provided immediate feedback to staff and patients on the hand hygiene status of a member of staff on approach to a patient. Compliance was logged automatically. Following a period of immediate feedback, no visual feedback was given for two weeks. Subsequently, feedback was given using red/green lights for 10 days, followed by retrospective feedback to the ward. Hand hygiene was verified independently by an observer.

FINDINGS: Hand hygiene compliance increased from 21% of 97 opportunities to 66% of 197 opportunities during active immediate feedback. Compliance decreased when feedback was provided to wards retrospectively. Six staff (26%) avoided wearing a badge, saying that it was too heavy or they were not on the ward all day. Only three of 30 patients stated that they would challenge staff who had not performed hand hygiene.

CONCLUSIONS: Automatic contact monitoring with immediate feedback was effective in increasing hand hygiene compliance, but feedback given retrospectively did not prevent a decrease in compliance.

KEYWORDS: Contact monitoring; Hand hygiene; Healthcare-acquired infection

PMID: 25115494


The Company

The VeraMedico Touch Monitoring technology has been developed by Veraz Ltd, whose headquarters are based in Lancaster, England. The business employs 16 people and has previously developed highly accurate process tracking and compliance monitoring tools for multinational companies.

The VeraMedico system has been in development for four years and has been partly funded by the Department of Health (England) through the Small Business Research Initiative. In June 2015 Veraz begins a major trial of the system at Manchester Royal Infirmary. This trial is a direct result of the work documented in Professor Peter Wilson’s paper “Effect of a contact monitoring system with immediate visual feedback on hand hygiene compliance” first published in 2014.


The Product

  1. VeraMedico is an Automated Information Capture & Reporting System which means that data input is fully automated and requires no manual support to capture or transmit. VeraMedico improves patient outcomes and reduces medical costs by instantly and electronically identifying when poor patient care occurs and then immediately alerts the individual concerned and prompts on a hierarchical basis that remedial action is required. In this way:
  • patients receive consistent, good quality care 24/7;
  • patients receive timely care;
  • avoidable lapses in care are instantly detected;
  • appropriate identifiable staff are instantly alerted to inconsistent, poor quality, or absent care to enable immediate remedial action;
  • communication with staff is multi-channeled: through their personal badges, mobile equipment;
  • information is captured and retained to enable constant improvement techniques to be applied to the care environment


  1. The Department of Health (England) have previously published a range of High Impact Interventions concerning best practice in the prevention and management of healthcare associated infections. The VeraMedico system complements these in every respect, as it does concerning advice and guidance similarly set out by the World Health Organization. These policy needs are embraced in the deployment of VeraMedico systems in relation to:

a. Hand Hygiene Compliance

b. Catheterization

c. Patient Repositioning

d. Hydration & Nutrition monitoring.


3. Additionally, VeraMedico is able to provide systems that allow for hospital management to better understand the extent of Critical Contact Time between healthcare workers and patients which has become an important proxy for productivity, safety and cost saving. In this same module it is possible to determine the location of each patient/staff member and provide a system through which Bed Management can be effectively accomplished in real-time.


  1. These various VeraMedico components can all be deployed in care-homes and in the domestic environment. The former being seen as a business sector that crucially needs such systems to monitor patient/healthcare worker interactions and patient safety and governance insofar that patients have been treated fully in line with their prescribed pathway. In the latter sense, the Department of Health and NHS England have both been consistent in their view that treating people in their homes as an alternative to hospitals is a central driver to improving care standards and radically reducing costs. VeraMedico is able to provide for these needs.


  1. Once one component of VeraMedico is installed in a healthcare facility and the “VeraMedico badge” is being worn by staff then these additional modules can be sold either individually or bundled at marginal cost.


  1. To watch a video which sets out the basic components of the Hand Hygiene system please refer to: https://www.youtube.com/watch?v=QLxTI8tzIio


fig1 A diagram detailing the process




Photographs of the VeraMedico badge.

Multiselect Ultimate Query Plugin by InoPlugs Web Design Vienna | Webdesign Wien and Juwelier SchönmannMultiselect Ultimate Query Plugin by InoPlugs Web Design Vienna | Webdesign Wien and Juwelier Schönmann