Clean Hands? There’s an App for That. – Part 3 of 3

Posted on by CDC's Safe Healthcare Blog
iScrub App
iScrub App
iScrub App

Guest Author — Dr. Philip Polgreen
iScrub Developer
Assistant Professor,
University of Iowa,
Roy J. and Lucille A. Carver College of Medicine

Imagine driving down a road and seeing a roadside speed device telling you that you are driving 20 miles per hour over the speed limit. Would you slow down? Chances are, most of us would. My colleagues and I are hoping a similar concept, combined with a free iPhone application, will also help healthcare personnel think twice and follow hand hygiene guidelines.

We all know that hand hygiene is important for preventing healthcare- associated infections (HAIs), yet hand hygiene rates among healthcare workers remain unacceptably low. There are many reasons why healthcare workers do not consistently perform hand hygiene, and many interventions have been suggested to change behavior. One promising approach is to remind healthcare workers how they are doing. The hope is that reminding healthcare workers about hand hygiene might alter their behavior. Perhaps if that behavior is firmly in place, such reminders might not be necessary in the future. Think about seatbelts.

There are a range of new technologies available, some commercially, to electronically monitor if healthcare workers are practicing hand hygiene. These systems can be costly and difficult to implement system wide. Therefore, most hospitals use human observers to monitor hand hygiene practices. Some new approaches combine electronic and human monitoring, using electronic devices to closely observe and record worker hand hygiene activity. This helps healthcare personnel, administrators, and researchers understand hand hygiene behavior and can help guide interventions in healthcare settings.

One new twist on this combination of monitoring is iScrub, a free iPhone application developed at the University of Iowa’s Computational Epidemiology group with help from the Centers for Disease Control and Prevention (CDC). iScrub is designed to replace clipboards and paper and allows observers to record hand hygiene behavior. The iPhone application helps decrease the time it takes to feed rates back to healthcare workers. It also standardizes reporting, avoids data entry errors, and makes it more fun to record observations. The app is free and available in the iTunes store. iScrub can be used on an iPhone, iPodTouch, or iPad. For more information on the iScrub application, please visit

Have you tried iScrub? What are your thoughts about monitoring on a large scale? Is this really needed in all hospital rooms? How does your facility ensure proper hand hygiene?

Posted on by CDC's Safe Healthcare Blog

9 comments on “Clean Hands? There’s an App for That. – Part 3 of 3”

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    I just got a IPhone for Christmas and downloaded the IScrub which I wanted badly since it came out. I am presently setting up my observation units and cannot wait to use it. It appears to be very user friendly and adaptable.

    I have an observation regarding the quality of hospital water.In my humble opinion,I believe that bacteriologically controlled water provided through 0.2 micron point of use water filters is the perfect solution to overcome more than half of all healthcare associated infections.

    I started to use the iScrub on my iphone and the ease of monitoring hand hygiene is great. The only issue I have is that I cannot keep notes specific to the observation. One of the observations required of me is to document names of who is non compliant in hand hygiene….

    Cost is always an issue as Carol discussed, but as Mike Edmond mentioned, you can purchase an iPod Touch for as little as $149 (refurbished) or $199 brand new. That is expensive for individual to purchase but compared to other hospital purchases, quite affordable. You don’t need an iPhone to use this; an iPod Touch is just as useful.

    I have been using this Application for just over a month now. At first it was not known that I was recording hand hygine on the units. Staff quickly caught on to what I was doing and I have seen a great improvement in hand hygine when I visit the units with my iphone out!
    Iscrub allows complete customization of your units (west wing, east wing?, or maybe you have ccu, icu, nicu, etc…) you can also customize disiplines (we are a teaching hospital so I added students to the list of those who I watch and record hand hygine on)
    Iscrub pro is due to come out soon, this not only allows you to record and send results to your email (where it opens in excell) but will also graph and chart trends!
    Iscrub is free, the Pro version will be paid but either way it’s worth the money and very useful and organized!

    We just did a trial of iScrub and think it’s great! We’re in the process of purchasing iPods for our hand hygiene observers so we can fully implement it.

    I think think this is a great idea, but could leave out a lot of the direct care staff that can’t afford an IPhone, but might benefit the most from quick reminders of breaks in hand hygiene. Maybe if staff had Iphones issued at work? Interesting thought and progress in the right direction.

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Page last reviewed: March 26, 2019
Page last updated: March 26, 2019