Proactive hand hygiene monitoring system

• US 20090195385A1
• Filed: 07/03/2008
• Published: 08/06/2009
• Est. Priority Date: 02/04/2008
• Status: Abandoned Application

• Current Assignee: Ching Ching Huang, Francine N. Hwang, Jennifer Peng
• Original Assignee: Ching Ching Huang, Francine N. Hwang, Jennifer Peng
• Inventors: Hwang, Francine N., Huang, Ching Ching, Peng, Jennifer
• Application Number:
  US12/217,415
• Publication Number:
  US 20090195385A1
• Time in Patent Office: Days
• US Class Current: 340/572.1
• CPC Class Codes: G08B 21/245 Reminder of hygiene compliance policies, e.g. of washing hands
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A system consists of remote identification tag (in the form of wristband) for personnel who must undergo hand hygiene frequently during a day'"'"'s work, programmed soap and rinse-free disinfectant dispensers, entry-exit sensors for controlled access areas and data transfer stations is used to monitor and record every handwashing procedure along with its thoroughness as well as every hand cleaning event with rinse-free disinfectant. The system will further prompt each worker'"'"'s identification tag at an appropriate place to examine its record to see whether a hand hygiene procedure is required before proceeding to his/her next task. The recorded data with time-date of each event will be transferred to a central computer for statistical analysis and presentation as a daily and/or periodic hand hygiene compliance report on each staff, department, shift and the entire institution.

Claims

1. A proactive hand hygiene monitoring system that employs interactive radio frequency identification (RFID) technology in the personnel identification tag:

(a) to monitor handwashing and hand cleaning with rinse-free disinfectant, (b) to determine the thoroughness of handwashing procedure undertaken, (c) to proactively prompt workers to clean their hands based on their recorded hand hygiene history and tasks at hand. The system is used to optimize the compliance by workers in the effort of reducing or eliminating cross infection that occur frequently in healthcare settings, food service and processing facilities, hotels, cruise lines, spas/fitness centers/gyms, schools and homes.

2. The system described in claim 1 consists of multiple units of the following components:

(1) An identification tag, in the form of a wrist band or wrist watch (ID band in short), assigned to each personnel to be monitored, which uses active RFID technology to interact (transmit and receive signals) with the pre-programmed soap and rinse-free disinfectant dispensers as well as entry-exit sensors to record the time-date (generated by an internal programmable clock circuitry of the ID band) of each of his/her hand hygiene event and its thoroughness. Based on the stored record and notification from a dispenser or entry-exit sensor, the ID band will also proactively prompt (by either vibration or low tone) the wearer to conduct hand cleaning prior to perform the next task, such as handling the next patient.

(2) Pre-programmed soap and rinse-free disinfectant dispensing (wall-mounted and counter top placed) units which will notify the user'"'"'s ID band via radio frequency of their own unique identification codes after triggering by the user.

(3) Entry-exit sensors using dual pulsed infrared or RF emitter-detector cones aiming at slight angle from each other to detect entry or exit of controlled access areas by one or more persons and inform the persons'"'"' ID bands via radio frequency to record the time-date of the unique identification codes of that sensor.

(4) Data transfer stations which will download the recorded data from every personnel ID band placed on their ports. They will verify the data integrity and convert them into a format (such as TCP/IP for Ethernet) to transmit via wired or wireless network to the central computer. They will also charge the internal battery of the docked ID band to maintain its functionalities.

(5) A central computer (which can be a personal computer or a server) which will receive the collected data from all the data transfer stations and processing them into a daily and/or periodic hand hygiene compliance report. It will also query the maintenance conditions of each component of this system (such as soap and rinse-free disinfectant refills as well as battery power level) and perform diagnostic to detect any malfunctions. During the data collection process, it will synchronize its clock with all the ID bands to assure the entire system is in synchronization with respect to timing of all events. It will also archive all the collected data and information.

3. The personnel identification tag described in claim 2, in which it can be in the form of a wrist band or wrist watch to be worn on the hand that receives soap or rinse-free disinfectant aliquot from a dispenser during a handwashing or cleaning procedure.

4. The wrist band or the integral band carrying the wrist watch as described in claim 3 can be composed with material impregnated with very small (such as nano size) silver particles as an antibacterial agent to allow the band to remain germ-free.

5. The system described in claim 1 will further use the following method to accurately identify the person undergoing hand hygiene process:

(1) All the personnel identification band/watch (ID band in short) employed with this invention will transmit its unique identification code via radio frequency (such as at 2.4 GHz) at 1 Hz or higher repetition rate continuously and at power level of a few microwatts, i.e. the code can only be detected by a built-in antenna in a pre-programmed dispenser within a few inches from an ID band.

(2) In a handwashing case, a soap dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or by depression of the dispensing tab (manual version). It will then read the personnel identification code transmitted by the ID band worn on the wrist of the person undergoing the handwashing procedure. It will be unable to read identification codes transmitted by other ID bands since the dispenser will be outside of the transmitting signal strength of those ID bands (10 inches or greater in distance to the dispenser). The dispenser will add this unique personnel identification code of the ID band as the leading element on its transmission signal string, which consists of the dispenser'"'"'s own identification code (to determine its type and location). The transmission will be at 1 Hz or higher repetition rate for a period of 2 seconds or less and at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this series of transmission.

(3) In hand cleaning case, a rinse-free dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or depressing of the dispensing tab (manual version). It will then read the personnel identification code transmitted by the ID band worn on the wrist of the person undergoing the hand cleaning procedure, and it will add this unique code as the leading element on its transmission signal string, which consists of the dispenser'"'"'s own identification code (to determine its type and location). The transmission will be at 1 Hz or higher repetition rate for a period of 2 seconds or less and at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this series of transmission.

(4) Every ID band employed has an imbedded instruction set which allows it to decipher only the RF signal with its own individual unique personnel identification code as the lead element. Therefore, only the ID band, worn by the person undergoing the handwashing or cleaning, can detect and decipher the signal string broadcasted by the dispensers.

(5) The ID band of the person undergoing handwashing or cleaning will record the soap or rinse-free disinfectant dispenser'"'"'s identification code along with time-date into its memory as a hand hygiene event. Since no other person'"'"'s ID band can respond to the dispenser'"'"'s transmitting data string without his/her ID code as the leading element, so no other person'"'"'s ID band can record this dispensing as a handwashing or cleaning event.

6. The system described in claim 1 can also employ the following method to accurately identify the person undergoing hand hygiene process:

(1) All the personnel identification bands employed with this invention will transmit its unique personnel identification code via a specific radio frequency (for example at 2.433 GHz) at 1 Hz or higher repetition rate continuously and at power level of a few microwatts, i.e. the code can only be detected within a few inches of the ID band. The imbedded instruction set within each ID band will operate its built-in RF transceiving circuitry at the specific frequency (say 2.433 GHz) unless it has been told to switch to a second frequency (such as 315 MHz or some slight shift in frequency from 2.433 GHz) for transceiving a preset length of time.

(2) In handwashing case, the soap dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or by the depressing of the dispensing tab (manual version). It will then read the identification code transmitted (say at 2.433 GHz frequency) by the ID band worn on the wrist of the person undergoing the handwashing procedure. It will unable to read identification codes transmitted by other ID bands since the dispenser will be outside of the transmitting signal strength radius of those ID bands (10 inches or greater in distance to the dispenser). The personnel identification code serves as a trigger for the dispenser to transmit a signal to this particular ID band immediately (such as within 1 second) at weak signal strength of a few microwatts to dictate the ID band to switch to a second frequency (such as 315 MHz or some slight shift in frequency from 2.433 GHz) for further transceiving. The dispenser will then send its own identification code (for determination of its type and location) at the second frequency and at 1 Hz or higher repetition rate for the duration of a proper handwashing routine as well as at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this transmission.

(3) In hand cleaning case, the rinse-free dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or the depressing of the dispensing tab (manual version). It will then read the personnel identification code transmitted by the ID band worn on the wrist of the person undergoing the hand cleaning procedure. The dispenser will transmit a signal to this particular ID band immediately (such as within 1 second) at weak signal strength of a few microwatts to dictate it to switch to a second frequency (such as 315 MHz or some slight shift in frequency from 2.433 GHz) for further transceiving. The dispenser will then send its own identification code (for determination of its type and location) at the second frequency and at 1 Hz or higher repetition rate for a duration of 2 seconds as well as at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this transmission.

(4) Every ID band employed has an imbedded instruction set which allows it to switch to a second RF frequency (when instructed by a dispenser'"'"'s signal) for transceiving during the subsequent time period before switching back to the first RF frequency. Therefore, the ID band worn by the person undergoing the handwashing or cleaning will communicate with the soap or the rinse-free disinfectant dispenser exclusive of all other persons'"'"' ID bands.

(5) The ID band of the person undergoes handwashing or cleaning will thus record the soap or rinse-free disinfectant dispenser'"'"'s identification code along with time-date supplied by its internal clock circuitry into its memory as a hand hygiene event without the possibility of being mis-identified.

7. The method described in claim 5 or 6 for providing accurate identification of the person undergoes hand hygiene procedure can be further supplemented with the following method during a handwashing or cleaning event when more than one person presented hands to a dispenser:

(1) All the personnel identification band/watch (ID band in short) employed with this invention will transmit its unique identification code and the time of last executed hand hygiene event via radio frequency at 2 Hz repetition rate and at power level of a few microwatts, i.e. the code can only be detected within a few inches of the ID band.

(2) When the RF circuitry of the dispenser detects more than one ID bands, the controller board will select the one with the longest time from last executed hand hygiene as the person undergoes the current hand hygiene event. It will then use this identification code as the lead element of its transmission signal string as described in claim 5 or requesting the ID band to switch to the second RF frequency for the subsequent communication as described in claim 6.

(3) For the handwashing event, the soap dispenser can further ensure the ID band selected under this described rare occasion is indeed the correct person by issuing its subsequent 5 timing marks (at 5 seconds apart) with alternating personnel ID code as lead element in the data string (i.e. the primary ID code selection is added to the first timing mark, then follows with the second choice ID code in front of the second timing mark and so on). Any ID band records show these skipped timing marks while with or without the dispenser identification code will all be given credit that handwashing event was executed by this person.

8. The system described in claim 1 can achieve its proactive prompting of the workers to undergo hand hygiene at appropriate time or occasion by the following method:

(1) Entry-exit sensor using dual pulsed infrared or RF emitter-detector cones aiming at slight angle from each other is employed to detect personnel entering into or exiting from a controlled access area, such as a patient room, a restroom, a surgery room or raw meat processing station.

(2) Upon detection of person(s) entering or exiting, the sensor will transmit a RF “

CHECK”

signal as the lead element followed by its own sensor identification code.

(3) An ID band, with a proper instruction set, worn by any person entering or exiting controlled access areas will receive and record the “

CHECK”

signal and the identification code of the entry-exit sensor along with time-date from its own internal programmable clock circuitry into its memory. It will also immediately examine its own memory for the time of the last hand hygiene event. If the time period is within a designated period (determined either by the institution implementing this hand hygiene monitoring system or preset at a specific value), then there is no further action. If the time period is longer than the designated period or the last handwashing result had a “

Fail”

grade, then this ID band will issue a prompt (in vibration or low tone) to alert the person to undergo hand cleaning before executing any task where cross infection can occur.

(4) 5 seconds after issuing the first prompt, the ID band will issue the second prompt (again, in vibration or low tone) if it has not received any dispenser identification code (which indicates the person has not responded to the first prompt). 5 seconds after the 2^nd prompt without getting any dispenser identification code, the ID band will record the event and issue a “

Fail to respond”

grade. Any dispenser identification code received by this ID band code as the lead element of the signal string will indicate proper response has been made by the person and will be recorded as such in his/her ID band'"'"'s memory.

(5) If the ID band determines the last time proper hand hygiene has been performed is within the designated time period after receiving a “

CHECK”

signal from an entry-exit sensor, then no prompt will be issued and only the time-date as well as the sensor identification code will be recorded by the ID band.

9. The system described in claim 1 can further achieve its proactive prompting of the workers to undergo hand hygiene at appropriate time or occasion by the following method:

(1) Every soap and rinse-free disinfectant dispenser is equipped with a pulsed infrared or RF proximity sensor on its front cover. This sensor will detect any person within its detection cone of 4 to 5 ft of distance (or longer).

(2) Upon detecting a person, the dispenser will send out a RF “

CHECK”

signal similar to the one sent out by an entry-exit sensor described in claim 8 part (2).

(3) The ID band, worn by any person walking by a dispenser, which receives the “

CHECK”

signal, will immediately examine its memory for the time of last hand hygiene event. If the time period is longer than a designated period or the last handwashing result had a “

Fail”

grade, then the ID band will issue a prompt (in vibration or low tone) to alert the person to undergo hand cleaning before proceeding.

(4) 5 seconds after issuing the first prompt, the ID band will issue the second prompt if it has not received any dispenser identification code (which indicates the person has not responded to the prompt). 5 seconds after the 2^nd prompt without getting any dispenser identification code, the ID band will record the event and a “

Fail to respond”

grade. Any dispenser identification code received with this ID band code as the lead element of the signal string will indicate proper response has been made by the person and will be recorded as such in his/her ID band memory.

(5) If the ID band examination of last time proper hand hygiene has been performed is within the designated time period after receiving a “

CHECK”

signal from any dispenser, then no prompt will be issued nor any recording of this event will be made by the ID band.

(6) When the instruction set residing in the central computer examines the hand hygiene data transmitted by an ID band, it will flag all the “

Fail to respond”

events and examine whether the person has performed a hand hygiene event after each “

Fail to response”

record within a specified time frame. If yes, then the “

Fail to response”

mark will be erased.

10. The system described in claim 1 can further employ the following method to guide and monitor the handwashing procedure (as recommended by the CDC) to assure thorough handwashing is done:

(1) Upon the dispensing of the soap, the dispenser'"'"'s controller will start a timer.

(2) It will transmit a timing mark signal every 5 seconds for a period of 25 seconds or longer.

(3) Each of the timing mark signals will have the personnel code of the ID band of the person undergoing the handwashing procedure as the lead element, so only this person'"'"'s ID band can receive, decipher and record these timing marks.

(4) During the first 10 second period (adjustable time length to as long as 20 seconds), the controller will flash a “

SCRUB”

display (which may be located on the front of the soap dispenser cover or as an independent unit) to remind the person undergoing the handwashing procedure to scrub his/her hands vigorously for the duration as stated in CDC handwashing guidelines.

(5) During the next 10 second period (again, adjustable time length), the controller will flash a “

RINSE”

display (which may be located on the front of the soap dispenser cover or as an independent unit) to remind the person to rinse his/her hands thoroughly as prescribed by CDC guidelines.

(6) When the person'"'"'s ID band records all 5 or more timing marks, it will then assign a “

Pass”

grade to this handwashing event. Missing the final two timing marks (the 4^th and 5^th in the 25-second scheme) will result a “

Fail”

grade for this event to be recorded.

11. The system described in claim 1 can be used to produce a daily and/or periodic hand hygiene compliance reports on each employee, each department and/or each shift of a facility which implemented this system. The report can include the whereabouts of the employees at what time and whether he/she had performed proper hand hygiene procedures before executing his/her assigned tasks as well as whether he/she had ignored proactive prompting.

12. The reports described in claim 11 can be further linked to other data available to the institution that has implemented this invention, such as patients that have hospital acquired infection (HAI) or food born illnesses traced back to a food processing plant. As an example, by the linkage, a hospital or nursing home can trace whether or not healthcare workers took care or had exposure to those HAI patients and examine the hand hygiene compliance record of those workers to determine which worker may be responsible for the HAI outbreak and what other patients may be at risk of HAI due to exposure to the same healthcare worker.

13. The reports described in claim 11 can be used as a part of performance criteria to penalize and/or promoting/rewarding workers.

14. The reports described in claim 11 can also be linked to the profit and loss data of an institution that has implemented this invention to view the relationship with respect to hand hygiene compliance by its workers.

15. The radio frequencies utilized in the system described in claim 1 are those permitted under the U.S. Federal Communication Commission for short distance communication without special licensing or permission at low power, such as 2.4 GHz, 2.433 GHz, 315 MHz, etc.

16. The components of the system described in claim 2 can all be powered by battery, with the exception of the central computer, to provide flexibility in location and ease of installation into a facility.

17. The personnel ID bands in conjunction with the data transfer stations as described in claim 2 can further serve as the linkage of all the soap dispensers, rinse-free disinfectant dispensers and entry-exit sensors to the central computer without any wired or wireless inter-connections among them.

18. The soap and rinse-free disinfectant dispensers of the system described in claim 2 can further employ circuitry to measure the amount of soap or disinfectant that has been dispensed. With this measurement, the dispenser can issue requests for refill by adding a code into the signal string it sends out to ID bands during hand hygiene procedures. By employing the ID bands to communicate the request for refill through the data transfer stations to the central computer, a daily refill order with the types of refills and the locations of the dispensers can be issued to the person or department responsible for such a ask.

19. The soap and rinse-free disinfectant dispensers along with the entry-exit sensors of the system described in claim 2 can further employ circuitries to measure the voltage level derived from their internal battery. With this measurement, the dispenser can issue a request for replacement by sending additional codes to ID bands during hand hygiene monitoring processes. By employing the ID bands to communicate the request for battery replacement through the data transfer stations to the central computer, a daily battery replacement order with the types and the locations of the components can be issued to the person or department responsible for such task.

20. Based on the system described in claim 1, there is a paper towel dispenser and maybe a hand lotion dispenser located next to each wash basin. Although they are not equipped with a pre-programmed controller and RF transceiver circuitry as the soap dispensers, their refill requirements can be linked to the soap dispenser usage. Therefore, this linkage, in the form of mathematical ratios, can be used by the central computer to issue daily refill orders for paper towel and hand lotion for specific wash basin.

21. The personnel ID bands in conjunction with the data transfer stations described in claim 2 can further be used as a clock-in and clock-out device for employees. When a worker picks up his/her ID band from a data transfer station at the beginning of his/her work shift, the station can record the ID code and the time. At the end of a shift, the person will place his/her ID band into one of the ports of a data transfer station, which will immediately identify the person and register the time of his/her shift end. The central computer will relay this work time-sheet data to an appropriate software package used by the institution implementing this invention.

22. The data transfer station described in claim 2 can also include a cover with ultraviolet lamps to produce light in the UVC wavelength (253.7 nm) region to sterilize all of the ID bands docked in the station periodically.

23. The data transfer station described in claim 2 can also include electromagnetic interference shielding for each individual ID band docking port to prevent data corruption during the transferring process between an ID band and the station.

24. The data transfer station described in claim 2 can also use contact-less electromagnetic energy transfer method to charge the internal batteries of the ID bands placed in its docking port, thus eliminating the alignment of contacts to achieve charging.

25. The system described in claim 1 can also include the ID bands that are worn on the ankle of the workers with a dispenser'"'"'s triggering sensor mounted remotely at the ankle level. This configuration may be applicable to facilities equipped with foot controlled faucets for wash basins.

26. The entry-exit sensors employed in claim 2 can further be used to track the patient care and/or workload of the healthcare workers during his/her shift.

27. All the ID bands in claim 2 will undergo daily clock synchronization with the central computer through the data transfer station to assure accurate hand hygiene compliance monitoring and reporting.

42. The usage of the system described in any preceding claims (1-41) in the healthcare facilities (hospitals, nursing care facilities, outpatient clinics, physician offices, dialysis centers, dental clinics and other medical diagnostic facilities) to monitoring the compliance of their staff with respect to handwashing and hand cleaning guidelines set out by relevant government agencies and professional associations for the reduction of cross infection incidences with said healthcare entity.

43. The usage of the system described in any preceding claims (1-41) in the food processing and delivery entities, lodging industry, cruise ships, spas, fitness centers, gyms, schools and homes to monitoring the compliance of their staff with respect to handwashing guidelines set out by relevant government agencies for the reduction of community acquired infections as well as food borne illness caused by non-compliance of the workers or members within said facilities.

28. A proactive hand hygiene monitoring system that employs a combination of passive radio frequency identification (RFID) and interactive radio frequency transceiving techniques in a personnel identification tag:

(a) to monitor handwashing and hand cleaning with rinse-free disinfectant, (b) to measure the thoroughness of handwashing procedure undertaken, (c) to proactively prompting the workers to clean their hands based on their recorded hand hygiene history and tasks at hand. This system is used to optimize the compliance by workers in the effort of reducing or eliminating cross infection occur frequently in healthcare settings, food service and processing facilities, hotels, cruise lines, spas/fitness centers/gyms, schools and homes.

29. The personnel identification tag described in claim 28 can be in the form of a wrist band or wrist watch to be worn on the hand that receives soap or rinse-free disinfectant aliquot from a dispenser during a handwashing or cleaning procedure.

30. The system described in claim 28 can consist of multiple units of the following components:

(1) An ID band (assigned to each personnel to be monitored) uses passive RFID technology to transmit its unique personnel ID code to the pre-programmed dispensers while using a battery-powered active RF transceiver circuit to interact with the pre-programmed soap and rinse-free disinfectant dispensers as well as entry-exit sensors to record the time-date (generated by an internal programmable clock circuitry of the ID band) of each of the wearer'"'"'s hand hygiene event and its thoroughness. This personal ID band also consists of an imbedded instruction set for it to decipher signals from the dispensers only with its own unique ID code as the leading element. In addition, the ID band will, based on the stored record and dispenser or entry-exit sensor notification, proactively prompt (by vibration or low tone) the wearer to conduct hand cleaning prior to perform the next task, such as handling the next patient.

(2) Pre-programmed soap and rinse-free disinfectant dispensing (wall-mounted and counter-top-placed) units will charge the passive RFID circuitry within an ID band for it to transmit one-time its unique personnel ID code. Upon receiving this ID code, the dispenser will transmit its own identification code (to provide information on its type, i.e. soap dispenser or rinse-free disinfectant dispenser, and location) with the received personnel ID code as the leading element of the RF transmitting signal string.

(3) Entry-exit sensor using dual pulsed infrared or RF emitter-detector cones aiming at slight angle from each other is employed to detect the entry or exit of a controlled access area of one or more persons. It will issue to the persons'"'"' ID bands via radio frequency a “

CHECK”

command along with its own unique sensor identification code (which represents its location) for the receiving ID bands to determine whether hand hygiene is needed prior to the ID band wearer performing the next task.

(4) A data transfer station which will download the recorded data from every personnel ID band placed in its ports. It will verify the data integrity and convert them into a format (such as TCP/IP for Ethernet) to transmit via wired or wireless network to the central computer. It will also charge the internal battery of the ID band to maintain its functionalities.

(5) A central computer (which can be a personal computer or a server) which will receive the collected data from all the data transfer stations and processing them into a daily and/or periodic hand hygiene compliance report. It will also query the maintenance conditions of each component of this system (such as soap and rinse-free disinfectant refills as well as battery power level) and perform diagnostic to detect any malfunctions. During the data collection process, it will synchronize its clock with all the ID bands to assure the entire system is in synchronization with respect to timing of all events. It will also archive all the collected data and information.

31. The system described in claim 28 will use the following method to accurately identify the person undergoing hand hygiene process:

(1) A personnel identification band/watch (ID band in short) employed with this invention includes a passive RFID circuitry, which will transmit its unique identification code via a specific radio frequency one time upon its charging capacitor being energized remotely by the antenna integrated within a soap or rinse-free disinfectant dispenser. Since this remote electromagnetic charging can only be accomplished within a short distance (a few inches) from the charging antenna, no other passive RFID circuitries located within other ID bands on the persons standing nearby will be charged up to transmit their ID codes. Therefore, the reading device integrated within the soap or rinse-free disinfectant dispenser can receive only the ID code of the person undergoing soap or disinfectant dispensing and will exclude other persons standing or walking nearby.

(2) In a handwashing case, the soap dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or by the depressing of the dispensing tab (manual version). It will transmit electromagnetic energy to charge up the passive RFID circuit in the ID band worn on the wrist of the person undergoing soap dispensing for this passive RFID circuit to transmit its identification code just one time. The dispenser'"'"'s RF transceiver circuitry will read this personnel identification code broadcast by the passive RFID circuit, then add this unique identification code of the ID band as the leading element on the dispenser'"'"'s outward series of transmission signal strings, which consists of the dispenser'"'"'s own identification code (to determine its type and location). This outward transmission will be at 1 Hz or higher repetition rate and at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this transmission. This transmission may be at a different frequency from the passive RFID transmission frequency.

(3) In hand cleaning case, the rinse-free dispenser'"'"'s controller circuitry will be activated by either the infrared proximity sensor sensing the presence of a hand underneath its dispensing nozzle (touchless version) or by the depressing of the dispensing tab (manual version). It will transmit electromagnetic energy to charge up the passive RFID circuit in the ID band worn on the wrist of the person undergoing rinse-free disinfectant dispensing for this passive RFID circuit to transmit its identification code just one time. The dispenser will then read the personnel identification code transmitted by the ID band worn on the wrist of the person undergoing the hand cleaning procedure, and it will then add this unique code as the leading element on its outward transmission signal strings, which consists of the dispenser'"'"'s own identification code (to determine its type and location). The transmission from the dispenser will be at 1 Hz or higher repetition rate and at power level of a few milliwatts to enable any ID bands within 3 to 4 ft of the dispenser to detect this transmission. Again, this transmission may be at a different frequency from the passive RFID transmission frequency.

(4) Every ID bands employed has an imbedded instruction set which allows it to decipher only the RF signal with its own individual unique personnel identification code as the lead element. Therefore, the ID band worn by the person undergoing the handwashing or cleaning will detect the signal string broadcasted by the dispensers and decipher the data string since it has its own code as the leading element of the detected signal string. Equally, all other ID bands worn by people near the person undergoing hand hygiene event will not be able to decipher the transmitting signals from dispensers, since their unique personnel ID codes are not the lead element of those signals.

(5) The ID band of the person undergoing handwashing or cleaning will record the soap or rinse-free disinfectant dispenser'"'"'s identification code along with a time-date from its own internal programmable clock circuitry into its memory as a hand hygiene event.

32. The system described in claim 28 can achieve its proactive prompting of the workers to undergo hand hygiene at appropriate time or occasion by the following method:

(1) Entry-exit sensor using dual pulsed infrared or RF emitter-detector cones aiming at slight angle from each other is employed to detect personnel entering into or exiting from a controlled access area, such as a patient room, a restroom, a surgery room or raw meat processing station.

(2) Upon detection of person(s) entering or exiting, the sensor will transmit a RF “

CHECK”

signal as the lead element followed by its own identification code.

(3) The ID band worn by any person entering or exiting a controlled access area will receive and record the “

CHECK”

signal along with the identification code of the entry-exit sensor and the time-date in its memory. It will also immediately examine its own memory for the time of last hand hygiene event. If the time period is within a designated period (determined by the institution implementing this hand hygiene monitoring system or a preset value), then there is no further action. If the time period is longer than the designated period or the last handwashing result had a “

Fail”

grade, then the ID band will issue a prompt (in vibration or low tone) to alert the person to undergo hand cleaning before executing any task, such as caring for a patient.

(4) 5 seconds after issuing the first prompt, the ID band will issue a second prompt if it has not received any dispenser'"'"'s identification code (which indicates the person has not responded to the first prompt). 5 seconds after the 2^nd prompt without getting any dispenser'"'"'s identification code, the ID band will record the event and a “

Fail to respond”

grade. Any dispenser'"'"'s identification code received with this ID band code as the lead element of the signal string will indicate proper response has been made by the person and will be recorded as such in his/her ID band memory.

(5) If the ID band examination of last time proper hand hygiene has been performed is within the designated time period after receiving a “

CHECK”

signal from the entry-exit sensor, then no prompt will be issued and only the time-date as well as the sensor identification code will be recorded by the ID band.

33. The system described in claim 28 can further achieve its proactive prompting of the workers to undergo hand hygiene at appropriate time or occasion by the following method:

(1) Every soap and rinse-free disinfectant dispenser is equipped with a pulsed infrared or RF proximity sensor on its front cover. This sensor will detect any person within its detection cone of say 4 to 5 ft (or longer) of distance.

(2) Upon detecting a person, the dispenser will send out a RF “

CHECK”

signal similar to the one sending out by the entry-exit sensor described in claim 32 part (2).

(3) The ID band worn by any person walking by the dispenser and receives the “

CHECK”

signal, will immediately examine its memory for the time of last hand hygiene event. If the time period is longer than a designated period or the last handwashing result had a “

Fail”

grade, then the ID band will issue a prompt (in either vibration mode or a tone mode) to alert the person to undergo hand cleaning before proceeding.

(4) 5 seconds after issuing the first prompt, the ID band will issue a second prompt if it has not received any dispenser identification code (which indicates the person has not responded to the prompt). 5 seconds after the 2^nd prompt without getting any dispenser identification code, the ID band will record the event and a “

Fail to respond”

grade. Any dispenser identification code received with this ID band code as the lead element of the signal string will indicate proper response has been made by the person and will be recorded as such in his/her ID band memory.

(5) If the ID band examination of last time proper hand hygiene has been performed is within the designated time period after receiving the “

CHECK”

signal from the dispenser, then no prompt will be issued nor any recording of this prompt will be made by the ID band.

(6) When the instruction set residing in the central computer examines the hand hygiene data transmitted by an ID band, it will flag all the “

Fail to respond”

events and examine whether the person has performed a hand hygiene event after each of “

Fail to response”

record within a specified time frame. If yes, then the “

Fail to response”

mark will be erased.

34. The system described in claim 28 can further employ the following method to guide and monitor the handwashing procedure to assure thorough washing has occurred per CDC handwashing guideline:

(1) Upon dispensing of soap, a dispenser'"'"'s controller will start a timer.

(2) It will transmit a timing mark signal every 5 seconds for a period of 25 seconds or longer.

(3) Each of the timing mark signals will have the personnel code of the ID band of the person undergoing the handwashing procedure as the lead element, so only this person'"'"'s ID band can receive, decipher and record the marks.

(4) During the first 10 second or longer period (adjustable length in time by changing the imbedded instruction set), the controller will flash a “

SCRUB”

display (which may be located on the front of the dispenser cover or as an independent unit) to remind the person undergoing the handwashing procedure to scrub his/her hands vigorously for the duration.

(5) During the next 10 second or longer period (again, adjustable length in time by changing the imbedded instruction set), the controller will flash a “

RINSE”

display (which may be located on the front of the dispenser cover or as an independent unit) to remind the person to rinse his/her hands thoroughly for the duration.

(6) When the person'"'"'s ID band records all 5 timing marks (or more), it will then assign a “

Pass”

grade to this handwashing event. Missing the last two timing marks (the 4^th, 5^th timing marks in the 25-second scenario) will result a “

Fail”

grade for this event to be recorded.

35. The ID bands employed in claim 28 can have its passive RFID circuitry completely independent to the battery-powered active RF transceiver and controller circuitry of the ID band. It can also be located at a different site on the band.

36. The system described in claim 28 will be used to produce daily and/or periodic hand hygiene compliance reports on individuals, departments and shifts. The reports can include the whereabouts of the employees at what time and whether he/she had performed proper hand hygiene procedures before executing his/her assigned tasks as well as whether he/she had ignored proactive prompting.

37. The system described in claim 28 can also produce the daily and/or periodic hand hygiene compliance reports that are linked to other data sources such as a patient'"'"'s name and patient room number where hospital acquired infection have taken place to pinpoint the workers that may be responsible for any cross infections.

38. The radio frequency utilized in the system described in claim 28 are those permitted under the U.S. Federal Communication Commission for short distance communication without special licensing or permission at low power, such as 134 KHz, 315 MHz, 915 MHz, 2.4 GHz, etc.

39. The personnel ID Bands in conjunction with the data transfer stations as described in claim 30 can further serve as the linkage of all the soap dispensers, rinse-free disinfectant dispensers and entry-exit sensors to the central computer without any wired or wireless inter-connection among them.

40. The system described in claim 29 can also include the ID bands that are worn on the ankle of the workers with dispenser'"'"'s triggering sensor mounted remotely at the ankle level. This configuration may be applicable to facilities equipped with foot controlled faucets for wash basins.

41. The wrist band or the integral band carrying the wrist watch as described in claim 29 can be composed with material impregnated with very small (nano size) silver particles as antibacterial agent to allow the bands to remain germ-free.