The influence of spatial configuration on the frequency of use of hand sanitizing stations in health care environments

Abstract

Background: The lack of user-friendly, accessible, and visible hand sanitizing stations (HSSs) in health care environments are significant factors affecting low hand hygiene compliance rates among caregivers.

Objective: To determine whether the simulated parameters of visibility and global traffic flow score for an HSS can influence the frequency of use of that HSS.

Methods: Space syntax was used to measure virtual simulation of spatial layouts of 3 units to provide quantitative visibility and global traffic flow scores for each HSS. The frequency of use of HSSs was measured for 2 weeks in 3 units in a community hospital through electronic tracking with self-developed motion sensors. Behavioral observations were also conducted during the same period to validate hand hygiene data obtained through electronic tracking. Linear models were used to tests how much variance in use is accounted for when visibility and/or global traffic flow are included in the model.

Results: When the visibility score for an HSS increases (decrease), frequency of use of the HSS will increase (decrease) (F [5, 65] = 13.877; P < .001). When the global traffic flow score for an HSS increases (decrease), frequency of use of the HSS will increase (decrease) (F [5, 65] = 13.877; P < .001).

Conclusions: This study proposed and validated a novel approach of using space syntax simulations to predict and optimize hand hygiene behavior.

Keywords: Hand hygiene; Health care quality; Health care-associated infection; Space syntax.