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LIANE HANSEN, host:

Here's a disturbing fact: Studies show that only about 40 percent of health care workers in this country wash their hand as often as they should. So some hospitals are testing new surveillance technologies to monitor their employees' hand-washing habits. From Birmingham, Alabama, Gigi Douban has more.

GIGI DOUBAN: The standard protocol in hospitals is for doctors and nurses to wash their hands on the way in to see a patient and on the way out. But that doesn't always happen they get busy; they forget. Happens to everyone, even Lindsey Ann Stone, a nurse at Princeton Baptist Hospital in Birmingham.

Ms. LINDSEY ANN STONE (Nurse, Princeton Baptist Hospital): How are you doing?

Unidentified Woman: I'm doing good.

Ms. STONE: How are you feeling today?

Unidentified Woman: Well, it's still pretty severe, but...

Ms. STONE: Yes, ma'am. You let us know if you need anything, but we'll be back, okay?

Unidentified Woman: All right.

DOUBAN: Wash your hands is a message Stone and her colleagues have heard over and over again.

Ms. STONE: Through orientation and bulletins that they put up and hand hygiene pamphlets and posters and everything that you can imagine. It's all over.

DOUBAN: Stone says she washes her hands a lot. She guesses at least 100 times a day. But hand washing is kind of like exercise - you don't do it nearly as much as you think you do.

So, hospital administrators installed new devices to track her hand hygiene. With information transmitted wirelessly through a special badge that she wears, they can tell when she entered a patient's room, whether she washed her hands and whether she washed again on the way out. That information is then recorded and sent to hospital officials. When she first heard about the new system, Lindsey Ann Stone says she had mixed feelings.

Ms. STONE: I was excited, but to be honest, I was a little nervous wondering how it was going to directly affect me as an RN.

DOUBAN: For one thing, she and her colleagues wondered how this information a sort of nice and naughty list on hand washing would ultimately be used.

Harvey Nix is the CEO of Proventix, the company that developed the monitoring system at Princeton Baptist. He says it's meant to be more a gentle prod than punitive.

Mr. HARVEY NIX (CEO, Proventix): If they're habitually not complying, we could actually send them an email or send them a text message, something that goes to them personally.

DOUBAN: Still, most people aren't thrilled about being monitored.

So the Centers for Disease Control is trying to gauge health care workers feel about these new devices. CDC epidemiologist Kate Ellingson says they're using focus groups to help tweak the technology. She says they're asking a number of questions.

Dr. KATE ELLINGSON (Epidemiologist, CDC): Not just how do you like it, what do you think of it, but do you see this as something that you would pay attention to, that would change your behavior?

DOUBAN: Ellingson says improving hand hygiene among health care workers has been a real challenge and that's come at a cost. According to the CDC, health care associated infections kill about 100,000 Americans a year, and costs billions of dollars.

For NPR News, I'm Gigi Douban in Birmingham.

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