HK1179040B - Monitoring system - Google Patents

Abstract

A group monitoring system for dispenser usage compliance is provided. The system is for a predetermined group of interest in a predetermined facility type. A dispenser data collection system is operably connected to a plurality of dispensers and is capable of providing information. The information includes a unique dispenser identifier and a number of dispenser usage events. The information from the data collection system is received and the predetermined group within which each dispenser is associated is determined. The number of dispenser usage events is determined. A benchmark which corresponds to dispenser usage opportunities particular to the predetermined group and particular to the predetermined time period is determined. The dispenser usage compliance index particular to the predetermined group and particular to the predetermined time period is determined by dividing the dispenser usage events for the predetermined group and the predetermined time period by a denominator which equals the benchmark.

Description

Monitoring system

Technical Field

The present invention relates to dispenser use, and more particularly to a method of monitoring dispenser use, wherein dispenser use may be associated with hand hygiene compliance or other dispenser use compliance.

Background

The spread of medically acquired infections (also known as HAI's) has become an ever-increasing challenge in the medical community. HAI's include the spread of bacteria, viruses, and other pathogenic microorganisms from multiple sources (such as patients or environmental surfaces) to other patients or surfaces via the hands of healthcare workers, which results in infection of previously uninfected patients. These problems have become apparent in recent years with an outbreak of SARS (severe acute respiratory syndrome) and the influenza a virus HIN1 epidemic. Likewise, medical institutions have been confronted with MRSA (methicillin-resistant staphylococcus aureus) and VRSA (vancomycin-resistant staphylococcus aureus) and resistant microorganisms for many years. Thus, there is a need to ensure that medical professionals comply with the best practices for hand hygiene. Hand hygiene may be achieved using liquids such as sanitizing products that do not require water or rinsing, or alternatively hand hygiene may be achieved using soap and water.

Likewise, there are other types of liquids that can be dispensed such as sunscreen, where the use of sunscreen also requires a method of monitoring, tracking and reporting. This approach may be very important, for example, in schools in australia where the incidence of skin cancer is very high.

Disclosure of Invention

In a first aspect, there is provided a group monitoring system for dispenser usage compliance in a predetermined group of interest in a predetermined institution, comprising the steps of:

providing a plurality of dispensers;

providing a dispenser data collection system operatively connected to each dispenser, the dispenser data collection system for providing information including a unique dispenser identifier for each dispenser and a plurality of dispenser usage events for each dispenser being used;

providing a predetermined reference, the predetermined reference corresponding to dispenser usage opportunities for a predetermined grouping and for a predetermined period of time;

receiving information from the dispenser data collection system and determining a predetermined grouping within which each dispenser is associated;

determining a predetermined period of time and a number of dispenser usage events within a predetermined grouping;

determining census data, the census data for a predetermined grouping and for a predetermined period of time; and

the dispenser usage dependency index for the predetermined grouping and for the predetermined period of time is calculated by dividing the dispenser usage events for the predetermined grouping and the predetermined period of time by a denominator, where the denominator is equal to the reference multiplied by the census data.

In another aspect, there is provided a group monitoring system for dispenser usage compliance in a predetermined group of dispensers of interest in an establishment, the system comprising a plurality of dispensers and a dispenser data collection system operatively connected to each dispenser, the dispenser data collection system being capable of providing information comprising a unique dispenser identifier for each dispenser and a plurality of dispenser usage events for each dispenser being used, the system comprising the steps of:

providing a predetermined reference, the predetermined reference corresponding to dispenser usage opportunities for a predetermined grouping and for a predetermined period of time;

receiving information from the dispenser data collection system and determining a predetermined grouping within which each dispenser is associated;

determining a predetermined period of time and a number of dispenser usage events within a predetermined grouping;

determining census data, the census data for a predetermined grouping and for a predetermined period of time; and

the dispenser usage dependency index for the predetermined grouping and for the predetermined period of time is calculated by dividing the dispenser usage events for the predetermined grouping and the predetermined period of time by a denominator, where the denominator is equal to the reference multiplied by the census data.

The amount of dispenser usage data over the predetermined period of time may be equal to the number of times the dispenser has been activated, with multiple activations over the predetermined activation period being considered a single dispenser usage event. The predetermined period of time is typically 1 second to 4 seconds.

The information may include a type of product in the dispenser, and the type of product in the dispenser is typically one of hand soap, sanitizer, lotion, cream, sunscreen, and shower gel.

The predetermined period of time may be one of a shift, a weekday, a weekend, and a holiday for each of the predetermined groupings in the predetermined organization type.

The reference may vary according to a predetermined mechanism type. The predetermined institution type may be one of a medical institution, a food processing institution, a food service institution, an educational institution, and a manufacturing institution. Alternatively, the predetermined facility type may be one of a teaching hospital, a non-teaching hospital, a long-term care facility, a rehabilitation facility, an independent surgical center, a medical professional clinic, a dental clinic, a veterinary facility, and a community care facility.

Similarly, the reference may vary according to a predetermined grouping of interest. The predetermined group of interest may be one of a medical department, a surgical department, an emergency care department, an intensive care department, an emergency care department, a pediatric department, an emergency department, an outpatient department, a specialty care department, a dermatologic department, an endocrine department, an gastroenterology department, a medical department, an oncology department, a neurologic department, an orthopedic department, an ophthalmic department, an otorhinolaryngological department, a neonatal department, a obstetrical department, a gynecological department, a cardiac department, a psychiatric department, a post-operative recovery department, a radiology department, an orthopedic department, and a urological department. The predetermined group may be one of a bed, a room, a ward, a department, a floor, an institution and a hospital group.

The benchmark in the denominator may be multiplied by census data. The census data may be one of a occupancy of a bed in the predetermined grouping, a day of a patient in the predetermined grouping, a visit of a patient in the predetermined grouping, a number of times a care of a bed in the predetermined grouping, and a number of staff members in the predetermined grouping.

A group monitoring system for dispenser usage compliance may include the step of determining a hand hygiene compliance index. The hand hygiene compliance index may include information from dispenser usage only; based on the dispenser usage compliance index and weighting information for investigating or directly observing the compliance data. Optionally, the hand hygiene compliance index includes weighted information based on the dispenser usage compliance index and the survey compliance data and direct observation compliance data.

The allocator data collection system may use a frequency selected from the group consisting of systems between 400MHz and 450MHz, systems between 850MHz and 950MHz, and systems between 2.4GHz and 2.5 GHz. Optionally, the dispenser data collection system is a hard-wired system.

The distributor data collection system may use frequencies in the system between 850MHz and 950MHz and have a transmission power between 10 milliwatts and 1000 milliwatts. The dispenser data collection system may include a network device for receiving data from a plurality of dispensers. Each hub receives data from one or more distributors, and each distributor is no more than 5740 feet from the hub of its respective pipeline.

In another aspect, a group monitoring system for dispenser usage data collection includes:

a plurality of dispensers, each dispenser having a sensor operably attached thereto to collect data from the dispenser;

a network device capable of receiving data from one of the plurality of distributors,

wherein the data includes a unique dispenser identifier for each dispenser and a plurality of dispenser usage events for each dispenser being used.

The data may be encrypted. Each divider may have a power usage of up to 1000 milliwatts.

Further features of the invention will be described and will become apparent from the following description.

The dispenser data collection system also includes a network device for receiving data from the plurality of dispensers.

The distributor data collection system further comprises a network device for receiving data from the plurality of distributors, the network device being a hub.

The distributor data collection system further comprises a network device for receiving data from the plurality of distributors, the network device selected from the group consisting of a wireless network device, a wireless hub, an ethernet hub, a repeater hub, a switch, an ethernet switch, a bridge, a router, an ethernet router, a wireless router, a gateway, and a gateway router.

The dispenser data collection system further includes a network device for receiving data from the plurality of dispensers, the network device being in wireless communication and each dispenser being no more than 5740 feet from its associated network device.

The dispenser data collection system also includes a plurality of network devices for receiving data from the plurality of dispensers.

The dispenser data collection system further comprises a plurality of network devices for receiving data from the plurality of dispensers, the packet monitoring system further comprises a server for processing the data, the server comprising one or more computers capable of receiving data from the network devices.

Drawings

The invention will now be described, by way of example only, with reference to the accompanying drawings, in which:

FIG. 1 is a schematic representation of five moments for hand hygiene in a medical environment;

FIG. 2 is a graph showing compliance index for pediatrics as compared to institutional goals and a hospital set;

FIG. 3 is a graph showing compliance index of intensive care units compared to institutional goals and hospital collections;

FIG. 4 is a flow chart illustrating different methods for calculating a hand hygiene compliance index;

FIG. 5 is a simple information panel showing an example of the manner information that may be presented to a user;

FIG. 6 is a diagram showing a wired distributor data collection system;

FIG. 7 is a diagram showing a wireless distributor data collection system similar to the system of FIG. 6;

FIG. 8 is a flow chart showing steps in a low frequency, low power wireless dispatcher data collection system;

FIG. 9 is a flowchart showing steps in a higher frequency, higher power wireless splitter data collection system;

FIG. 10 is a diagram showing a lower power and lower frequency allocator data collection system located within a particular area; and

fig. 11 is a diagram showing a higher power and higher frequency allocator data collection system located within the same particular area as covered by fig. 10.

Detailed Description

It is not a simple matter to measure the adherence of medical personnel to hand hygiene compliance guidelines. There are uncertified standards or benchmarks that may be used. However, there is a need for very clear monitoring and measuring of hand hygiene compliance. Thus, it is necessary to determine whether or not a hand hygiene action has occurred when a hand hygiene action instruction is present. Five moments in the medical environment for hand hygiene activities are shown in figure 1. These five hand hygiene actions were developed instantaneously by the world health organization. The hand hygiene activity may be sanitized with sanitizing products that do not require water or rinsing, or alternatively the hand hygiene activity may be rinsed with soap and water.

As used herein, the term "hub" refers to any network device capable of sending and receiving packets of information, and should not be construed as limited to ethernet hubs, network hubs, or repeater hubs as conventionally described in the computer network literature.

As used herein, the word "operably connected" or "operably attached," such as "X operably connected to Y" or "X operably attached to Y," indicates that X and Y may be interacting due in operation, although X and Y need not be physically connected or physically attached. In this word, the terms "connected" and "attached" are to be interpreted in an operational sense, and not necessarily in a physical sense. For example, if X and Y are devices capable of sending packets to each other directly or through a network, X and Y are operatively connected. As a further example, if X is a device and Y is a sensor, and Y is capable of sensing one or more events that occur as a result of X operation, then X and Y are operably connected.

Referring to fig. 1, five hand hygiene activities are shown generally at 10. In particular, they are before contact with the patient 12, before sterile work 14, after exposure to bodily fluids 16, after contact with the patient 18 and after contact with the patient environment 20. When considering compliance, if a healthcare worker washes or disinfects his or her hands only 6 times (10 should be disinfected), they are said to have a compliance rate of 60%.

There are a number of ways to measure compliance, namely direct observation, remote observation, self-reporting and dispenser usage data or product usage data. Each approach has its own benefits and challenges. Specifically, direct observation provides specific information, techniques, and instructions for hand hygiene activities. However, the labor and resources required to collect such data is intensive. Typically, if this type of data is collected, it is only collected for a small sample of the total hand hygiene opportunities, and therefore has a typically low level of statistical reliability. The data has a bias between the sampling of certain shifts and departments. Likewise, it has been shown that there are also problems related to the reliability of the internal evaluator (observer), so it is difficult to compare the results from one observer with the results of another observer.

Moreover, it has been shown that if people know that they are being viewed or studied, there is a greater likelihood that the compliance rate is artificially higher than it is actually. This is also known as the Hawthorne Effect (Hawthorne Effect). Evidence supporting this was found in the 2009 german study, which compares product usage data with direct observation data and found that direct observation compliance rates were 2.75 times higher than compliance rates for product usage. Thus, product use is accepted by professionals because of a more accurate measurement of true compliance rates.

With respect to remote viewing such as video, the advantage is that it has small deviations and it can be operated at any time and in any units of day or night. However, this data collection method is expensive because of the installation and maintenance of the video equipment and the time to review the video, which, like direct viewing, lacks some internal evaluator reliability. Moreover, it may be biased based on the video location. Also, there may be privacy issues related to the video location.

With respect to the self-reporting option, it has the advantage of low cost, and it encourages medical personnel to have self-awareness of hand hygiene. However, this type of data collection is generally less reliable, and most experts in this field consider this method to be of little, if any, value.

In a typical medical environment, hand hygiene liquid is stored and dispensed from the dispenser to the hands, so there is a direct correlation between dispenser use or activation and the hand hygiene event being performed. The dispenser usage data may provide the amount of product used per patient day, or the number of times the dispenser is used per patient day. Its advantage is low monitoring cost. Moreover, it provides an overall measure of use and it has no selective bias. However, it does not provide feedback or techniques for indication. Furthermore, it does not identify individual employees who perform poorly. The use of a measuring dispenser has many other advantages. In particular, in addition to low cost, it is less resource intensive and therefore more efficient than observations. Likewise, it may be implemented manually or electronically. It allows the entire tissue trend to be tracked over time. It may be unobtrusive and is designed to take up little additional space. Dispenser usage can be easily measured for all duty hours 24 hours a day, 7 days a week. It requires minimal staff training. It can be easily implemented in many different medical environments.

In embodiments herein, the dispenser is able to determine when the dispenser is enabled. The number of dispenser usage events within the predetermined period of time is equal to the number of dispensers that have been activated, and multiple activations within the predetermined activation period are considered a single dispenser usage event. Those skilled in the art will appreciate that multiple activations within a short period of time will typically mean that one user has activated the dispenser multiple times, rather than having multiple users activated the dispenser in close proximity. Thus, multiple activations within a 1 to 4 second timeframe would be considered a single dispenser use event. For hand soap and hand sanitizer in medical institutions, this is typically set at 2.5 seconds. However, when the dispenser usage is monitored for different types of products in different types of establishments, different activation periods may be set. Typically, the dispenser is calibrated to dispense a predetermined amount of liquid for each activation. Thus, dispenser activation is directly related to product use. Thus, one skilled in the art will appreciate that the volume used or the dispenser activation may be used when determining the dispenser usage compliance index.

In one embodiment, only dispenser usage is used to calculate a dispenser usage compliance index. In another embodiment, a combination of two or more of dispenser usage data, direct observation data, and measurement data (e.g., self-reported data or patient survey data) may be used to provide combined hand hygiene information. Preferably, the information will be automated and real-time. In one embodiment, the system will provide automated multi-modal manual hygiene compliance reporting. Preferably, these reports will be provided by a department or department. Such automated reporting would provide hospital management with tools to give feedback on compliance, targeted interventions designed to improve compliance, and reward improved performance.

In one embodiment, the hand hygiene compliance index will include a plurality of modes of determining compliance. In particular, it will include data from dispenser usage, observation and/or measurement. Each method is weighted and combined to establish a single compliance index. This method is weighted based on their statistical validity.

In order to use the measure of compliance by a dispenser, the monitored mechanism is provided with a plurality of dispensers. The organizations may be divided into predetermined groups of interest. The institution may be a teaching hospital, a non-teaching hospital, a long-term care facility, a rehabilitation facility, an independent surgical center, a medical professional clinic, a dental clinic, a veterinary facility, and a community health care facility, as well as other medical environments where hand hygiene compliance is an important issue. Alternatively, the system herein may be used in any establishment where it is desirable to monitor hand hygiene at various stages of food preparation, including slaughterhouses, preparing precooked foods, and restaurants. The monitoring system may also be used to monitor compliance by applying the dispensed lotion as a sunscreen.

To determine dispenser usage compliance, the number of hand hygiene events and a reference for a predetermined area or group and for a predetermined time are required. Dispenser usage compliance dispenser usage events are divided by a denominator, wherein the denominator comprises at least a portion of the reference. The reference is specifically for a predetermined group and specifically for a predetermined time period. Usage can be measured for each dispenser in the predetermined group in substantially real time and the captured data transmitted electronically. Those skilled in the art will appreciate that a limited amount of time is required to retrieve data from the distributor to the hub to the server (described below), but this is settable for very frequently transmitted messages. While reports are typically accessible at 24 hours, 7 days a week, reports are most likely presented for no more than one day, and more likely for no more than one week or month. However, if there are special episodes of the disease in the ward, the usage of the dispenser can be monitored more frequently by access reports as needed. The number of hand hygiene events within a predetermined period of time is equal to the number of times the dispenser has been activated, wherein multiple activations within the predetermined activation period are considered a single dispenser use event. It is not uncommon for some people to activate the dispensing system multiple times rather than only once when they use the dispensing system. Thereby determining the number of times the dispenser is activated in order to accurately determine the correct number of dispensing usage events. However, when there are multiple activations within a predetermined activation period, it is considered a single dispenser usage event. The reference is the number of times the dispenser should be used for a predetermined group in a predetermined period of time.

When dispenser usage compliance relates to hand hygiene compliance in a healthcare facility, the benchmark relates to five hand hygiene moments for a predetermined set within a predetermined time period. In order to determine the baseline for the predetermined area and time, it is necessary to determine the hand hygiene events that should occur for each patient for the predetermined area and time. This is accomplished with reference to five hand hygiene moments as shown in fig. 1. Those skilled in the art will appreciate that the reference will vary depending on a number of variables. For example, if the medical facility is a teaching facility, it may be that more medical professionals will need to see the patient, and the benchmark may be higher. If the predetermined time period is a night shift as opposed to a day shift, the reference may change if this is a weekday as opposed to a holiday or weekend. The criteria will likely vary depending on the type of department. For example, intensive care units have a higher benchmark than orthopaedic departments. The denominator may depend on census data. In particular, to determine the denominator, the benchmark is multiplied by census data. For some healthcare facility departments or predetermined groups of interest, the census data will be a hospital bed occupancy. In some medical or ad hoc institutions' beds, the bed occupancy may approach 100%, while in other departments or institutions, the bed occupancy may vary widely. In other departments, such as emergency or outpatient departments, the census data may be the number of patients seen during the shift or predetermined period of time in question. It may also be the number of times the bed care time is provided during the predetermined period in question.

Further, those skilled in the art will appreciate that the benchmarks may be determined by experimentation or other means of the medical facility, or that there may be default benchmarks provided, wherein the default benchmarks are provided to the user by the dispenser supplier or the central authority.

The following are some classifications that may be used to determine the correct reference. The groups or types set forth below relating to medical institutions and types of departments within medical institutions are Centers for Disease Control (CDC) location tags and are by way of example only. Those skilled in the art will appreciate that there are many different ways of dividing departments in a medical facility.

Type of institution-medical

Hospital-non-teaching

Hospital-teaching (subject to medical college)

Rehabilitation mechanism

Long-term nursing mechanism

Independent surgical center

Medical office/physician's office

Dental clinic

Veterinary clinic

Type of institution-non-medical

School/education

Correction

Military affairs

Food service (such as restaurant)

Food processing (such as production of food products)

Pharmaceutical production

Commercial building/organization (such as a manufacturing plant where workers must apply protective emulsions according to a flow)

Other mechanisms of concern for infectious diseases transmitted by hand

Emergency nursing department

Burn emergency nursing

Medical heart chest emergency nursing

Medical emergency nursing

Medical/surgical emergency care

Department of neurology emergency nursing

Neurosurgery emergency nursing

Prenatal first-aid nursing

Respiration first-aid nursing

First-aid nursing for chest and heart surgery

Surgical emergency nursing

Wound emergency nursing

Pediatric emergency nursing department

Pediatric burn emergency nursing

Pediatric cardio-thoracic emergency nursing

Pediatric surgery emergency nursing

Pediatric medical/surgical emergency care

Pediatric nerve emergency nursing

Pediatric neurosurgery emergency nursing

Pediatric respiration emergency nursing

Pediatric surgery emergency nursing

Pediatric wound emergency nursing

Neonatal department

Health baby nursing (grade I)

Neonate born ICU (grade II)

Newborn emergency nursing (grade II/III)

Newborn emergency nursing (grade III)

Special nursing area for inpatients

Long Term Acute Care (LTAC)

Professional nursing area for bone marrow transplantation

Acute dialysis department

Blood/tumor SCA

Solid organ transplantation SCA

Pediatric bone marrow transplantation SCA

Pediatric dialysis SCA

Pediatric blood/tumor SCA

Pediatric long-term emergency care

Pediatric solid organ transplantation SCA

Adult ward for inpatient

Antenatal nursing ward

Burn ward

Behavioral health/psychosis ward

Ear/nose/throat disease room

Gastrointestinal ward

Sickroom for senile diseases

Urogenital ward

Gynecological ward

Prison department

Childbirth ward

Waiting for delivery, recovery, postpartum room (LDRP)

Medical ward

Medical/surgical ward

Mixed acute ward

Age-mixed and acute ward

Neurology ward

Neurosurgery ward

Ophthalmic ward

Orthopedic trauma ward

Orthopedics ward

Orthopedic ward

Order-reducing ward

Lung ward

Rehabilitation ward

School doctor's office

Surgical ward

Middle wind (acute) department

Remote measuring department

Vascular surgery ward

Pediatric ward for inpatient

Teenagers' behavior health

Pediatric burn ward

Pediatric behavioral wellness

Ear-nose-throat department for pediatrics

Pediatric urinary system

Medical pediatric ward

Pediatric medical/surgical ward

Pediatric mixed emergency (if the patient is of mixed age, using mixed age found in the patient's adult ward)

Paediatrics department of psychiatric wards

Pediatric neurosurgery ward

Pediatric orthopedic ward

Paediatrics rehabilitation ward

Pediatric surgical ward

Order-reducing department

Order-reducing department

Pediatric hypertension department

Operating room

Cardiac catheter chamber

Caesarean delivery room

Interventional radiology room

Operating room

Post-anesthesia care department/recovery room

Long term care

Hospital patient safety maintenance station

Long-term nursing department

Long-term nursing department for senile dementia

Long-term care behavioral health/mental analysis department

Ventilator dependent department

Long-term nursing rehabilitation department

Laboratory identification events only (LabID)

Inpatient in institution

Outpatient in institution

Other zones

Combined hospital bed for all inpatients

Float

Sleep study (for inpatients and outpatients)

Transportation service

Treatment room

Outpatient position

Emergency care environment

24 hours observation area

Outpatient operation center

Outpatient in institution

Mobile emergency services/EMS

Emergency department for outpatient

Pediatric surgery center for outpatient department

Orthopaedic center for outpatient patients

Outpatient surgical recovery room/post-anesthesia care department

Pediatric emergency department

Therapeutic separation surgery department room

Emergency nursing center

Clinic (non-emergency) environment

Allergy clinic

Behavior health clinic

Blood sampling center

Heart rehabilitation center

Heart disease clinic

Continence clinic

Dermatology clinic

Diabetes/endocrine clinic

Ear-nose-throat clinic

Family medical clinic

Clinic for genetic diseases

Gynecological clinic

Integrated medical center

Hyperbaric oxygen therapy center

Infusion center

Neurological clinic

Occupational health care clinic

Professional treatment clinic

Ophthalmology clinic

Orthopaedic surgery clinic

Ostomy clinic

Dental clinic for outpatient

Outpatient GI clinic

Clinic for outpatient blood/tumor

Hemodialysis clinic for outpatient

Outpatient HIV clinic

Clinic for outpatient medical treatment

Rehabilitation clinic for outpatient

Pain clinic

Pediatric behavior health clinic

Pediatric heart disease center

Pediatric clinic

Pediatric dental clinic

Pediatric dermatosis clinic

Pediatric diabetes/endocrine clinic

Pediatric gastrointestinal clinic

Pediatric blood/tumor clinic

Kidney clinic for pediatrics

Pediatric plastic surgery clinic

Pediatric rheumatism clinic

Pediatric scoliosis clinic

Physical therapy clinic

Doctor's office

Pedicure clinic

Antenatal clinic

Lung clinic

Rheumatism clinic

Medical rooms for schools or prisons

Sample collection area (medical treatment)

Language disorder correction clinic

Surgical service clinic

Infant clinic

Wound, stoma and continence clinic

Endoscope examination room

Radiology, including nuclear medicine

Movable blood sampling center

Mobile MRI/CT

Communication location

Blood sampling (blood driving sport)

Home care

Nursing mechanism based on family

Position outside the mechanism

Sample Collection area (Community)

Non-patient care location

Administrative district

CDC location and description

Life rescue area

Blood bank

Central sterilizing supply part

Central waste area

Clinical chemistry

Mechanism floor

General laboratory

Blood laboratory histology/surgical pathology

Housekeeping/environmental service

Laundry room

Microbiological laboratory

Taiping room/corpse examination room

Pharmacy

Physical equipment operation center

Common area in a facility

Serum laboratory

Polluted living area

Virus laboratory

Time period

Day shift-working day/weekend or holiday

Night shift-working day/weekend or holiday

First shift/second shift/third shift-for weekdays/weekends or holidays

First shift/second shift/third shift/fourth shift/fifth shift-for weekdays/weekends or holidays

Predetermined time of day

Once the multi-mode compliance index is calculated, a plurality of different reports may be generated. The reports may be used to help determine situations where more or different hand hygiene compliance efforts (such as additional training) need to be implemented. The report may be presented in a simple graphical format as shown in fig. 2 and 3, where fig. 2 shows the hand hygiene index of a pediatric department as compared to a hospital set and a goal or benchmark, and fig. 3 shows the hand hygiene index of an intensive care department as compared to a hospital set and a goal or benchmark. Fig. 4 shows some different reporting options. Fig. 5 shows a slate that illustrates a more complex way of presenting information.

Those skilled in the art will appreciate that there are a number of different options relating to how the hand hygiene compliance index may be presented. A representation of the different ways in which the hand hygiene compliance index may be presented is shown schematically at 100 in fig. 4. For example, a user may use a default benchmark 102 or a user-defined benchmark 104 in determining dispenser usage compliance. By default basis, the hand hygiene compliance indication may be based on its own dispenser usage compliance index 106, or it may include multimodal data. If it includes multimodal data, the dispenser usage adherence index can be combined with the survey data 108; or combined with the direct observation data 110; or combined with survey data and direct observation data 112. Alternatively, the hand hygiene compliance index may be expressed as a dispenser usage compliance index 114 based on itself, by a user-defined benchmark; or in combination with survey data 116; or combined with the direct observation data 118; or combined with survey data and direct observation data 120. If the dispenser usage compliance index is combined with other data, the data is weighted as it is combined to provide the hand hygiene compliance index.

The Hand Hygiene Compliance Index (HHCI) may be expressed as a formula. Hand hygiene events or dispenser usage events are used to calculate HHCI or dispenser adherence indices. The event is the same as dispenser activation except that multiple activations occur within a predetermined activation period. The predetermined activation period is between 1 and 4 seconds and preferably 2.5 seconds. Wherein multiple activations occur within a predetermined period of time, all activations occurring within the predetermined period of time constituting a single hand hygiene event. In these cases, multiple activations within, for example, 2.5 seconds are recorded as a single event with n activations. These events were used for HHCI molecules.

(\frac{\sum_{s}^{e}events{\sum_{s}^{e}(census_{dp}*

benchmark_{dp})}*w_1)+(observed*w_2)+(survey*w_3)

Wherein:

e = end day

s = start day

events = number of actual hand hygiene events

dp = day (e.g., first class, second class)

census (census data) = daytime patients

benchmark = desired activation for daytime

w1= weighting of the specific components. w1+ w2+ w3 must be equal to 1.

w2= weighting of the specific components. w1+ w2+ w3 must be equal to 1.

w3= weighting of the specific components. w1+ w2+ w3 must be equal to 1.

Direct observation method = observation of hand hygiene compliance. The total between 0 and 100 represents the percentage of compliance.

Patient survey method = patient survey hand hygiene compliance. The total between 0 and 100 represents the percentage of compliance.

The numerator is the total number of events for a predetermined period of time.

The denominator represents the total number of expected hand hygiene events for a predetermined period of time.

To calculate the denominator, the day's demographic data is first multiplied by the day's benchmark. This produces a desired number of events during the day. The expected events for each day of the predetermined period are added together resulting in a total expected activation of the period defined by the start time and the end time.

The weighting is applied by multiplying the weighting by the hand hygiene compliance of the component.

There are three cases where hand hygiene compliance is calculated.

1) Dispenser activation

In this case, w1 is equal to 1, and there is no exponential observation or investigation of hand hygiene components.

2) Dispenser enablement and investigation or observation data

In this case, the sum of w1 and w2 or w3 is 1, and the index is calculated by multiplying the weight by the dependency component. For example, a group monitoring system that records hand hygiene compliance over a period of time is to weight 90 by 0.8. Patient study compliance was weighted by 0.2 versus 70. There are no observations for calculating (hand hygiene compliance index) HHCI. The recorded hand hygiene compliance was 90x0.8 or 72 and the patient investigated hand hygiene compliance was 70x0.2 or 14. The hand hygiene compliance index for this period was 86 or 72+ 14.

3) Dispenser enablement with simultaneous patient survey and observation compliance data

In this case, the sum of w1+ w2+ w3 is 1, and the index is calculated by multiplying the weight by the dependency component.

For example, a group monitoring system that records hand hygiene compliance over a period of time is to weight 90 by 0.6. Patient survey compliance was weighted by 0.2 versus 70, and observation data compliance was weighted by 0.2 versus 70. The recorded hand hygiene compliance was 90x0.6 or 54, the patient investigated hand hygiene compliance was 70x0.2 or 14, and the observed compliance was 70x0.2 or 14. The hand hygiene compliance index for this period was 82 or 54+14+ 14.

Those skilled in the art will appreciate that there are many ways in which information may be expressed. A simple information board is shown at 130 in fig. 5. Simple information panels include graphical representations of usage 132, summary reports 134, and specific dispenser usage 136.

Each dispenser has a unique identifier and the identifier is associated with the soap dispenser to the sanitizer dispenser. This is important to distinguish between hand hygiene events using soap as a disinfectant. This would be particularly important for agencies with specific disease episodes that require soap to the disinfectant (or vice versa), such as in the case of diseases that result in clostridium biothrix (also known as c.diff.) which is the most difficult form of spore to eliminate and can usually be removed from the hands only by hand washing, as the presence of reliable data supports that hand disinfectants are not an effective way to kill c.diff spores.

A system may be designed in which the mechanism has the ability to adjust the reference or use its own selected reference. Those skilled in the art will appreciate that organizations have a wide range of reports that they can generate. For example, it may generate reports by the department; reports are generated by the hospital, for example, comparing departments to departments, departments to hospitals, or hospitals to hospitals. Likewise, those skilled in the art will appreciate that dispenser usage data may be integrated with the institution procurement component.

The system may be connected to a wired system as shown at 30 in fig. 6, or to a wireless system as shown at 50 in fig. 7. In the wired system 30, the distributor 32 is connected to a hub 34 and/or a gateway 36. The gateway is connected to a data grooming server 38, the data grooming server 38 in turn being connected to a hand hygiene compliance index calculation server 40. Those skilled in the art will appreciate that the data consolidation server 38 may include one or more computers.

Similarly, in wireless system 50, distributor 52 is wirelessly connected to hub 54 and/or gateway 56. The gateway is wirelessly connected to a data consolidation server 58, preferably over the internet via GSM (global system for mobile communications) or other communication standards and network protocols. The data grooming server 58 is connected to a hand hygiene compliance index calculation server 60. The data grooming server 58 and the hand hygiene compliance index calculation server 60 may be the same server. Each dispenser 52 has a sensor located therein that is preferably capable of storing data relating to up to 100 or more activations. Those skilled in the art will appreciate that 100 is merely exemplary and that in general each dispenser may only need to store data relating to a few activations. This minimizes the chance of losing data if queued for receipt by the hub. Data is abruptly sent between the distributor 52 and the hub 54 and gateway 56 depending on time or memory. Preferably, the data is abruptly sent from the gateway 56 to the server 58 by way of GSM. The data may be sent to the foreign server 60 for data processing.

Although the network is described as a plurality of network devices consisting of hubs and gateways, other network devices may be used. Some non-limiting examples include wireless hubs, ethernet hubs, repeater hubs, switches, ethernet switches, bridges, routers, ethernet routers, wireless routers, and gateway routers.

Those skilled in the art will appreciate that packets may be sent in the aforementioned networks using a variety of protocols. Optionally, the packets may be sent in accordance with the Internet Protocol Suite (IPS), which includes the Transmission Control Protocol (TCP) and the Internet Protocol (IP), commonly referred to as TCP/IP. This approach moves much of the network complexity to the edge of the network, i.e., to each distributor and server, as compared to the alternative. When using this scheme, the dispatcher may send packets via TCP or UDP (user datagram protocol), although other transport layer protocols may be used in the IPS specification.

Alternatively, the packets transmitted between the distributor, hub and gateway may have a defined format different from that specified in the IPS specification, and may be finally repackaged into IPS-compatible packets when transmitted to the foreign server 60. Since existing internet infrastructure is available for transmission, it may be desirable to send information out-of-the-way using the internet protocol suite. There are a number of different considerations when designing a wireless system. In particular, there is only a limited number of frequencies that are typically available for "unlicensed" transmission. The "unlicensed" frequencies available in each country may be different. "unauthorized" frequencies may have a wide range of use, for example they may be used in tag security systems in retail stores, remote control devices or garages, Wi-Fi networks and many RFID tags (radio frequency identification device tags). Preferably, the system described herein will use "unlicensed" frequencies. For example, title 47 of federal regulations in the United states, section 15, covers the use of "unauthorized" transmitters in the United states. In particular, the following table shows the commonly available frequencies and associated power levels.

In contrast, the European radio protocol is encapsulated by R & TTE (instructive 1999/5/EC) and supported by the CEPT recommendation 70-03. Compliance with R & TTE guidelines may be achieved in 2 ways, the first by applying a "coordination standard" and the second by obtaining approval from a public agency. The following table is based on the recommendations CEPT70-03 and the coordination standards EN300-220 and EN 300-440.

The frequency and power selected will affect the design of the system. A flow chart showing the steps implemented in low frequency (400 MHz to 450 MHz) low power (up to 10 mW) is schematically shown at 70 in fig. 8. A similar flow chart for a higher frequency (850 to 950 MHz), high power (up to 1W) wireless system is shown diagrammatically at 140 in fig. 9.

A flow chart showing the steps implemented in low frequency (400 MHz to 450 MHz) low power (up to 10 mW) is schematically shown at 70 in fig. 8. Once there is a distributor usage event, the distributor 52ID is transmitted to any or all of the hubs 54 within the transmission distance 72. After receiving the dispatcher ID transmission, the hub replies with an acknowledgement 74. This is sometimes referred to as a "handshake". If the dispenser does not receive the acknowledgement, the dispenser will retry until the acknowledgement is successfully received. The hub adds the data and a time stamp to the ID to generate dispenser usage data. The hub 54 transmits the distributor usage data 76 through the hub network elements until the data 76 reaches the gateway 56. Each successive hub 54 in the link acknowledges receipt of the dispenser usage data from the previous hub 78. If the originating hub does not receive an acknowledgement, it will retry until it successfully receives an acknowledgement. Hub 54 within the transmission range of the gateway transmits the dispenser usage data through gateway 80. When the gateway 56 captures the startup data, it sends an acknowledgement back to the originating hub 82. If the originating hub does not receive an acknowledgement, it will retry until it successfully receives an acknowledgement. The gateway 56 arranges the data received from the rest of the system into transport packets of a predetermined format. The predetermined format may specify a predetermined size or a predetermined header size. These data packets are transmitted to the packet collating server 84. Preferably, the data is transmitted over the internet to the finishing server 58, preferably via GSM. When the data packet is received or captured by the data marshalling server 58, an acknowledgement is sent back to the gateway 86. If the gateway 56 does not receive the acknowledgement, it retries until the acknowledgement is successfully received. This type of system is often referred to as a mesh network.

It will be appreciated that such an acknowledgement may be a dedicated packet, or may be contained in a specified offset within the packet header.

Optionally, the acknowledgement may be sent back to the distributor from the server, rather than being transmitted between each hub and distributor. In this scheme, each hub forwards acknowledgement packets to their addressed location, e.g., a dispatcher or server.

Alternatively, a system of higher frequency (850 MHz to 950 MHz) and higher power (up to 1W) is shown diagrammatically at 140 in FIG. 9. After establishment, the distributor 52 sends a request to the nearest hub 54 to request a hub ID (identification) and time update 142. The hub 54 responds with the requested information 144 and this is synchronized with the distributor. If the dispatcher does not receive a response, it repeats until a successful synchronization is achieved. Once the setup is complete and there has been a dispenser usage event, the dispenser 52 transmits dispenser data including dispenser ID, time, date of use, dispenser usage event 146 to its synchronized hub 54. Upon receiving the splitter data, the hub replies with an acknowledgement 148. The acknowledgement includes a time update. This is sometimes referred to as a "handshake". If the dispenser does not receive the acknowledgement, the dispenser will retry until successful. The hub collates the data received from the distributor to form a transport packet 150 of a predetermined size (a predetermined number of bytes). The data packet is then transmitted through the hub network until the data reaches the gateway 56. When the receiving hub captures a packet, it sends an acknowledgement back to the originating hub 152. This confirmation also includes a time update. If the originating hub does not receive an acknowledgement, it retries until successful. The hub transmits the data packet to the gateway 154 within the transmission range of the gateway 56. When the gateway captures the packet, the gateway sends an acknowledgement back to the originating hub 156. This acknowledgement includes a time update. If the originating hub does not receive an acknowledgement, it will retry until successful. The gateway marshals all data received from the rest of the system into transport packets 158 of a predetermined size (bytes). This data packet is then transmitted via GSM to the data marshalling server 58. When the packet is captured, the data marshalling server sends an acknowledgement back to gateway 160. This acknowledgement also includes a time update. If the gateway 56 does not receive the acknowledgement, it will retry until successful. This type of system is often referred to as a mesh network.

Referring to fig. 10 and 11, examples of dispenser data collection systems are shown at 90 and 96, respectively. A plurality of dispensers 52 are located around the departments of the facility being monitored. A plurality of receivers or hubs 54 are located around the bed within range of the dispensers such that each dispenser is within range of at least one receiver. As described above, when each dispenser 52 is used, it transmits its unique identification code, date and time to the hub 54, which in turn transmits the data to the gateway 56 and then to the server 58. Typically, in large organizations, the system uses a mesh network. During the data transfer phase, there is a "handshake" between the sender and the receiver, whether they are distributor and hub, hub and gateway, or gateway and server. The handshake acknowledges that the data was received and instructs the dispatcher to delete the information from memory. The server 36 may be located in-situ or ex-situ.

Thus, there are a number of conflicting benefits when designing a system herein for use by a medical facility (e.g., a hospital). In particular, the system would require multiple (100 or more likely 1,000) self-powered (battery-powered) activation sensors that require reliable wireless transmission of usage data around large, cluttered hospital buildings, and the data is transmitted via GSM links to the internet for external data manipulation. The battery of each sensor preferably has a long life (over 5 years), is physically small (< packaging of the card), and is preferably low cost to the system. Preferably, the system does not interfere with the medical device, is legitimate, and utilizes licensed free radio frequencies.

The solution is practical low power + low cost + minimal RF interference, which recommends a system that complies withType network architecture, utilizing an ultra low power transmitter (typically 0.1 mw) with minimal processing power. This gives low sensor hardware cost (currently about $ 5/node) and requires that an electrical outlet-powered network be installed in each building to act as a communication and data processing "backbone". Knowledge of the radio frequency propagation within a building will enable the skilled person to select the smallest available frequency to maximise the range for a given power output (reducing the hard-linked "backbone" cost and enhancing reliable communications) and so he will preferably select between 400MHz to 450 MHz. This will give 50ftTypical indoor range. Such a system is shown at 90 in fig. 10. By way of example, in a facility requiring about 4000 dispensers, 200 hubs are required, as shown in fig. 10.

In contrast, when the direct sequence spread spectrum technique (DSSS) is utilized at higher frequencies (868-; this increases the range (typically 330 ft) and therefore increases the cost (currently around $ 11/node) and power consumption. However, in another embodiment shown at 96 in fig. 11, it has been determined that a reduction in the density of the electrical outlet supply network backbone saves cost, at least offsetting the increase in sensor cost. The additional power requirement due to the 5,000 doubling length of transmitted power can be offset by significantly more efficient firmware running in the sensors, enabled by the larger capacity microprocessors required to facilitate DSSS. For example, by increasing the department cost and output power, in this embodiment, the system cost and complexity is significantly reduced without significant battery life penalty (a single board mounted battery that fits space requirements preferably gives a lifetime of more than 5 years).

In system 96, about 20 to 40 hubs are required for about 4000 dispensers. The distance between the distributor and the hub can be up to 5740 feet. However, within a medical facility, the distance is typically 330 feet, and in some cases greater than 330 feet depending on the object between the dispenser and the hub. Those skilled in the art will appreciate that the maximum number of distributors per hub is limited by the available network bandwidth and the number of bits per address. Since each dispenser has substantially lower activity on the network, a greater number of dispensers may be supported on a network where all devices are continuously active. Implementations of hubs using 8-bit addressing would be limited to connecting to 255 distributors, although other implementations with more bits per address may allow for additional distributors, e.g., up to 10,000 distributors. Typically, within a medical facility, each hub receives data from about 200 dispensers. In system 96, the transmission power is up to 1000 milliwatts. For the system 96, a high level of data encryption may be used, providing a higher level of security than provided by a lower frequency system. System 96 employs a direct sequence spread spectrum transmission technique that has a reduced interference rate and is allowed to operate at greater power than lower frequency systems.

Thus, higher frequencies (typically between 850MHz and 950 MHz) are favored over lower frequencies (typically between 400MHz and 450 MHz). Higher frequency systems use more power and higher frequencies, contrary to conventional knowledge related to systems of this type of data distribution. Some preliminary processing may be performed at the distributor, since the distributor uses more power.

A group monitoring system for dispenser usage compliance within a predetermined group of interest at a predetermined institution comprising the steps of: providing a plurality of dispensers; providing a dispenser data collection system operably connected to each dispenser, the dispenser data collection system capable of providing information including a unique dispenser identifier for each dispenser, a plurality of dispenser usage events for each dispenser being used; receiving information from the data collection system and determining a predetermined grouping associated with each dispenser; determining a number of hand hygiene events in a predetermined grouping within a predetermined period of time; determining a benchmark corresponding to an allocator usage opportunity for a predetermined grouping and for a predetermined period of time; dispenser usage compliance indexes for predetermined groupings and for predetermined periods of time are calculated by dividing hand hygiene events for the predetermined groupings and predetermined periods of time by a denominator, where the denominator is equal to a reference. The number of hand hygiene events within a predetermined period of time is equal to the number of times the dispenser is activated, wherein multiple activations within the predetermined activation period are considered a single dispenser use event. It is not uncommon for some people to activate the dispensing system multiple times rather than only once when they use the dispensing system. Thus, in order to determine the correct number of times the dispenser has been used, it is necessary to determine the number of times the dispenser has been activated. However, when there are multiple activations within a predetermined activation period, it is considered a single dispenser usage event.

The dispenser usage compliance index may further include at least one of direct observation data and survey data. The data used in the dispenser usage compliance index is weighted. The predetermined period of time may correspond to a predetermined grouping of shifts within a predetermined institution.

The benchmarks may vary depending on the intended institution, the type of department within the institution, the time of day, and the day of the week. The denominator may also be the benchmark multiplied by census data. The census data is dependent on the grouping of interest and may be a bed occupancy, a patient day, a patient visit, a number of bed care times, or a number of staff members. The predetermined grouping may be a bed, room, ward, department, floor, or facility.

The allocator data collection system uses a frequency of one of the systems between 400MHz and 450MHz and the systems 850MHz and 950 MHz. In one embodiment, the allocator data collection system uses one frequency of the system between 850MHz and 950MHz and has a transmission power of up to 1000 milliwatts. It also includes a plurality of hubs for receiving data from the plurality of dispensers, and each hub receives data from one or more dispensers, each dispenser being generally no greater than 5740 feet from its associated hub. Data between the distributor and the hub is encrypted.

A group monitoring system for dispenser usage data collection comprising: a plurality of dispensers; a plurality of hubs, each hub capable of receiving data from one or more distributors, and each distributor being no more than 5740 feet from its associated hub, and data being transmitted between 850MHz and 950 MHz.

In general, the systems described herein are directed to dispenser compliance systems, and by way of example, to hand hygiene compliance systems. As required, embodiments of the present invention are disclosed herein. The disclosed embodiments are, however, exemplary only, and it should be understood that the invention may be embodied in many different and alternative forms. The figures are not drawn to scale and some features may be exaggerated or minimized to show details of particular elements while related elements may have been eliminated to prevent obscuring novel aspects. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present invention. For purposes of teaching and not limitation, the illustrated embodiments use a compliance system with respect to the dispenser.

As used herein, the terms "comprises" and "comprising" are to be interpreted as non-exclusive and open-ended, rather than exclusive. In particular, the terms "comprises" and "comprising" and variations thereof, when used in this specification including the claims, are intended to imply the inclusion of stated features, steps or components. The terms are not to be interpreted to exclude the presence of other features, steps or components.

Claims (43)

1. A group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type, comprising the steps of:

providing a plurality of dispensers;

providing a dispenser data collection system operatively connected to each dispenser, the dispenser data collection system for providing information including a unique dispenser identifier for each dispenser and a plurality of dispenser usage events for each dispenser being used;

providing a predetermined reference corresponding to dispenser usage opportunities for the predetermined grouping and for the predetermined period of time;

receiving the information from the dispenser data collection system and determining the predetermined grouping within which each dispenser is associated;

determining a predetermined period of time and a number of dispenser usage events within the predetermined grouping;

determining census data, the census data for the predetermined grouping and for the predetermined period; and

calculating a dispenser usage dependency index for the predetermined grouping and for the predetermined period of time by dividing the dispenser usage events for the predetermined grouping and the predetermined period of time by a denominator, wherein the denominator is equal to the reference multiplied by the census data.

2. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 1, wherein the number of dispenser usage events within the predetermined period of time is equal to the number of times the dispenser has been activated, and multiple activations within a predetermined activation period are considered a single dispenser usage event.

3. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 2, wherein the predetermined activation period is 1 to 4 seconds.

4. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment as recited in claim 1, wherein said information further comprises a product type in said dispenser.

5. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type as claimed in claim 4, wherein the product type is selected from hand soap, sanitizer, lotion, cream, sunscreen and shower gel.

6. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as claimed in claim 1 wherein the predetermined period of time is selected from one of shift, weekday, weekend and holiday, each of the predetermined group in the predetermined type of institution.

7. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 6, wherein the predetermined reference varies according to the predetermined institution type.

8. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 7, wherein the predetermined type of institution is one of a medical institution, a food processing institution, a food service institution, an educational institution and a manufacturing institution.

9. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 8, wherein the predetermined type of institution is selected from the group consisting of a teaching hospital, a non-teaching hospital, a long-term care institution, a rehabilitation institution, an independent surgical center, a medical professional clinic, a dental clinic, a veterinary institution and a community care institution.

10. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 9 wherein the predetermined reference varies according to the predetermined group of interest.

11. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution of claim 10, wherein the predetermined group of interest is selected from a medical department, a surgical department, an emergency care department, an intensive care department, an emergency care department, a pediatric department, an emergency department, an outpatient department, a specialty care department, a dermatological department, an endocrine department, an gastroenterology department, a medical department, an oncology department, a neurology department, an orthopedic department, an ophthalmic department, an otolaryngology department, a neonatal department, a obstetrics and gynecology department, a cardiac department, a psychiatric department, a post-operative recovery department, a radiology department, an orthopedic department, and a urology department.

12. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type as claimed in claim 11, wherein the predetermined group is selected from the group consisting of hospital bed, room, ward, department, floor, institution and hospital group.

13. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 12, wherein the census data is selected from the group consisting of bed occupancy in the predetermined group, patient day in the predetermined group, patient visit in the predetermined group, number of care hours in the predetermined group, and staff members in the predetermined group.

14. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution of claim 13, further comprising determining a hand hygiene compliance index, wherein the hand hygiene compliance index comprises at least the dispenser usage compliance index.

15. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution of claim 14 wherein the hand hygiene compliance index includes weighted information based on the dispenser usage compliance index and one of survey compliance data and direct observation compliance data.

16. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution of claim 14 wherein the hand hygiene compliance index includes weighted information based on the dispenser usage compliance index and survey compliance data and direct observation compliance data.

17. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 16, wherein the frequency used by the dispenser data collection system is selected from the group consisting of a system between 400MHz and 450MHz, a system between 850MHz and 950MHz, and between 2.4GHz and 2.5 GHz.

18. The packet monitoring method for dispenser usage compliance in a predetermined packet of interest in a predetermined type of establishment of claim 17, wherein the dispenser data collection system uses a system with a frequency between 850MHz and 950MHz and has a transmission power of up to 1000 milliwatts.

19. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 18 wherein each hub receives data from up to 10000 dispensers and the distance between each dispenser and its associated hub is no greater than 5740 feet.

20. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 16 wherein the dispenser data collection system is a hard wired system.

21. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment as recited in claim 20, wherein said dispenser data collection system further comprises a plurality of hubs for receiving data from said plurality of dispensers.

22. The packet monitoring method for dispenser usage compliance in a predetermined packet of interest in a predetermined type of establishment of claim 21, wherein said data is encrypted.

23. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 1, wherein the predetermined reference varies according to the predetermined institution type.

24. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 23, wherein the predetermined type of institution is selected from the group consisting of rehabilitation facilities, educational medical facilities, non-educational medical facilities, chronic care facilities, community care facilities, schools, educational facilities, food service facilities, food processing facilities, outdoor work sites, and commercial facilities.

25. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 24, wherein the predetermined reference varies according to the predetermined group of interest.

26. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type of claim 25, wherein the predetermined group of interest is selected from a medical department, a surgical department, an emergency care department, an intensive care department, an emergency care department, a pediatric department, an emergency department, an outpatient department, a rehabilitation department, a long-term care department, a specialty care department, a dermatologic department, an endocrine department, an gastrointestinal department, a medical department, an oncology department, a neurologic department, an orthopedic department, an ophthalmic department, an otorhinolaryngological department, a neonatal department, a gynecological department, a cardiac department, a psychiatric department, a postoperative recovery department, a radiology department, an orthopedic department, and a urological department.

27. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined establishment type according to claim 26, wherein the predetermined group is selected from the group consisting of bed, room, ward, department, floor, and establishment.

28. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 27, wherein the census data is selected from the group consisting of bed occupancy in the predetermined group, patient day in the predetermined group, patient visit in the predetermined group, number of bed care hours in the predetermined group, and staff members in the predetermined group.

29. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 1, wherein the frequency used by the dispenser data collection system is selected from the group consisting of a system between 400MHz and 450MHz, a system between 850MHz and 950MHz, and between 2.4GHz and 2.5 GHz.

30. The packet monitoring method for dispenser usage compliance in a predetermined packet of interest in a predetermined type of establishment of claim 29, wherein the dispenser data collection system uses a system with a frequency between 850MHz and 950MHz and has a transmission power of up to 1000 milliwatts.

31. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment as recited in claim 30, wherein said dispenser data collection system further comprises a plurality of hubs for receiving data from said plurality of dispensers.

32. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment of claim 31 wherein each hub receives data from up to 10000 dispensers and the distance between each dispenser and its associated hub is no greater than 5740 feet.

33. The packet monitoring method for dispenser usage compliance in a predetermined packet of interest in a predetermined type of establishment of claim 32, wherein said data is encrypted.

34. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 1, wherein the census data is selected from the group consisting of bed occupancy in the predetermined group, patient day in the predetermined group, patient visit in the predetermined group, number of care hours in the bed in the predetermined group, and staff members in the predetermined group.

35. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution of claim 1, further comprising determining a hand hygiene compliance index, wherein the hand hygiene compliance index comprises at least the dispenser usage compliance index.

36. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type as recited in claim 35, wherein the hand hygiene compliance index includes weighted information based on the dispenser usage compliance index and one of survey compliance data and direct observation compliance data.

37. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined institution type as recited in claim 35, wherein the hand hygiene compliance index includes weighted information based on the dispenser usage compliance index and survey compliance data and direct observation compliance data.

38. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment as recited in claim 1, wherein said dispenser data collection system further comprises a network device for receiving data from said plurality of dispensers.

39. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment according to claim 1, wherein said dispenser data collection system further comprises a network device for receiving data from said plurality of dispensers, said network device being a hub.

40. The packet monitoring method for dispenser usage compliance in predetermined packets of interest in a predetermined institution type as recited in claim 1, wherein the dispenser data collection system further includes a network device for receiving data from the plurality of dispensers, the network device selected from the group consisting of a wireless network device, a wireless hub, an ethernet hub, a repeater hub, a switch, an ethernet switch, a bridge, a router, an ethernet router, a wireless router, a gateway, and a gateway router.

41. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of establishment as recited in claim 1, wherein said dispenser data collection system further comprises a network device for receiving data from said plurality of dispensers, said network device being in wireless communication and the distance between each dispenser and its associated network device being no greater than 5740 feet.

42. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 1, wherein the dispenser data collection system further includes a plurality of network devices for receiving data from the plurality of dispensers.

43. The group monitoring method for dispenser usage compliance in a predetermined group of interest in a predetermined type of institution as recited in claim 1, wherein the dispenser data collection system further includes a plurality of network devices for receiving data from the plurality of dispensers, the group monitoring system further including a server for processing the data, the server including one or more computers capable of receiving data from the network devices.