Development and Evaluation of BLE-Based Room-Level Localization to Improve Hand Hygiene Performance Estimation

Hand hygiene is one of the most effective ways to prevent infection transmission. However, current electronic monitoring systems are not able to identify adherence to all hand hygiene (HH) guidelines. Location information can play a major role in enhancing HH monitoring resolution. This paper proposes a BLE-based solution to localize healthcare workers inside the patient room. Localization accuracy was evaluated using one to four beacons in a binary (entrance/proximal patient zone) or multiclass (entrance/sink/right side of the bed/left side of the bed) proximity-based positioning problem. Dynamic fingerprints were collected from nine different subjects performing 30 common nursing activities. Extremely randomized trees algorithm achieved the best accuracies of 81% and 71% in the binary and multiclass classifications, respectively. The proposed method can be further used as a proxy for caregiving activity recognition to improve the risk of infection transmission in healthcare settings.