GB2492912A

GB2492912A - Zone based hand hygiene compliance system

Info

Publication number: GB2492912A
Application number: GB1217739.0A
Authority: GB
Inventors: Kaveh Seyed Momen; Geoffrey Roy Fernie; Oleksandr Igorovich Levchenko; Graham Clive Hufton
Original assignee: University Health Network; University of Health Network
Current assignee: University Health Network; University of Health Network
Priority date: 2008-09-29
Filing date: 2009-09-29
Publication date: 2013-01-16
Anticipated expiration: 2029-09-29
Also published as: GB201217739D0; GB2492912B; GB2476908B; GB201107048D0; GB2476908A; GB2492912A8; WO2010034125A1

Abstract

A wearable monitoring unit comprising: a receiver operable for receiving zone data from a zone beacon; an alerting unit; a memory having stored thereon a group of hygiene status subroutines, each according to a corresponding infection risk level; and a processor module configured to: receive said zone data via said receiver; identify an infection risk level associated with said zone data; select a hygiene status subroutine according to said identified infection risk level; execute the selected hygiene status subroutine; and upon user non-compliance with said selected hygiene status subroutine, activate said alerting unit. The wearable monitoring unit may be configured to receive hygiene event data from a hygiene event detector via the receiver and to process the hygiene event to determine user compliance with the hygiene status subroutine. The monitoring unit may also comprise a time of day module for adjusting the infection risk level and therefore the selection of the hygiene status subroutine as a function of time of day. The hygiene status subroutine can also comprise a timer for timing compliance of the user with the selected subroutine, the duration of the timer being set as a function of the infection risk level.

Description

HAND HYGIENE COMPLIANCE SYSTEM

REFERENCE TO COPNDING APPLICATIONS

100011 The entire subject matter of US Provisional application 60192U,779 filed March 30, 2D07 arid entitled I LAND I IYGLENE COMPLtANCE SYSTEM is incorporated herein by refererice The entire subject mutter cf US Provisional application 60(960,521 fded October 2.

2007 and entitled HAND HYGIENE COMPLIANCE SYSTEM also incorporated herein by reference. The entire subject matter of US application 121078,186 tiled March 27,2008 and entitled HAND HYGIENE COMPLIANCE SYSTEM is also incorporated herein by relerence The entire subject matter of PCT application PCT/CA20081000534 filed March 27, 2008 and entitled HAND HYtB1ENE COMPLIANCE SYSTEM is also incorporated herein by reference.

The entire subject matter of US application 61/136720 tiled September29, 2008 and entitled HAND HYGIENE COrtPLlANCE SYSTEM is also incorporated herein by reference. Applicant claims priority to each of Lhe above mentioned applications.

TECHNICAL FIELD

100021 The present invention relates to hand hygiene systems arid tnre specifically to hand hygiene monitoring syslems.

BACKGROUND OF THE INVENTION

L00031 Approximately one in 10 people admitted to Fiopitals in the United States acquire a new infection during their stay, These nosccomial infections resuLt in an estimated 100,000 deaths per year in Ihe United Slates. Nosoconlial infeclions increase the length of patient stays in hospital, contributing to increased healthcare staffing levels, increased costs and increased use of resources. This situation conti-ibutes significantly to the overall stress on the hea!thcare systems and increases wait times, It is estimated that approximately halt of these nosocemial infections are the result of inadequate hand hygiene compliance by healthcare stall.

L0004] There is considerable evidence that hand hygiene compliance is a primary means to reduce nesocomial infections arid the transmission of pathogens. Paftogens are normally present on the skin of healthcare workers and patients and on surfaces surrounciirig The patient. These organisms can be transferred ID healthcare workers hands where they can survive For periods ranging Ironi minutes to houfs. The final step in the transmission process is the transfer of organisms from the contaminated hands of the caregiver to other patients or clean environmental surfaces-Alcohol-based hand rubs seem to be significantly more effective than washing with soap and water and in the reduction of transmission of pathogens.

[0005] Wearabte dispensers of alcohol-b3sed hand rub can provide ready access hand hygiene without the need to visit a fixed band washing station and can reduce the time required to perform hand hygiene especially for busy staff such as nurses.

[0006] Unfortunately, published studies have generatly found that conipliance with hand hygietne requirements by healihoare workera averages about 40%. Various traditional educational and management interventions can increase awareness and improve this in the short term but generally do not provide sustainable improvements.

L00071 Some prier art systems such as United States patent 5.392MB to Smith, entitled Hand Washing Compliance Measuremeni and Monitoring System monitor compiiance but have several possible disadvantages. A possible disadvanlage of the system of Smith is that there is eithernQ prompting ci the userwhen ii is necessary to perloriru tiarid washing, or the user is prompted every time They enter a zone, irrespective of whether they penforriied appropriate hand washing or not. Neither scenario would seem to encourage the user or caregiver to improve hand washing complianee Other possible disadvantages of the syslerri of Smith are inerferercc between sfte ED trarLsmitters betyveen closely spaced sites and lack eta method to prompt users to wash their hands after extenced periods of time within he same zone.

[0008J Accordingly, an imprrmecl system and method to encourage increased hard hygiene compliance in environments where the transfer of pathogens can be dangerous, remains highly desirable.

SUMMARY OF THE INVENTION

00O9] It is therefore an object of the present invention to probdde art improved system and method to encourage increased hand hygiene compliance by increased convenience and appropriate prompting when needed.

100101 Accordingly, an aspect 1the present invention provides a method of encouraging compliance of hand hygiene in a system having a disinfectant dispenser, a dispensing detector, a wearable zone sensor, a controller, a timer means and an alerting means. The method comprises slaps of detecting a change of zone of the wearable zone sensor: responsive to detecting a change of zone, starting a pre&et first timer; and responsive to expiration of Ihe tirst timer, activating the alerting means O01'Ii Another aspect of the present invention provides a method ole000Llraglng compliance of hand hygiene in a system having a disinfectant dispenser, a cLspensing detector, a wearable zone sensor] a controller, a timer means and en alerting (prompting) meant The method comprises a system!or precisely defining zones around different patients, entrance ways, eguipnient and other specific areas where hard cleansing is needed. The method a150 comprises steps of starting a timer when the hand hygiene system is used; prompting for hand cleansing if the timer has expired vlien entering a zone; detecting the entry of a wearable zone sensor moving into a defined zone; and prompting for band cleansing when entering a new patient zone or when leaving the room through a zone marking the entrance or leaving the bathroom.

P012) Some embodiments further comprise a step of disabling the first timer responsive to sensing dispensing of disinfectant [0013] In some embodiments, [e step of detecting a change at zone further comprsas steps of: sensing a zone identifier signal; decoding a first zone identifier from the zone identifier signal; comparing the first zone identifier with a stored zone identther determining a change of zone if said first zone identifer differs from said stored zone identifier; and storing said first zone identifier a.s the stored zone identifier [0014] Some ernbodinients further comprise a slep of logging the time associated with detecting a change of zone [0016] Some embodiments further comprise a step oF longing the time associated with activating the alerting means (0016] Some embodiments further comprise a step of logging said first zone identifier associated with detecting a change of zone.

100171 Scrre embodiments further coniprise a step oltransniittirig said zone identifier signi from a zone tranrirnitler.

In some embodiments, the step of transmitting comprises transmitting an ultrasonic signal.

10019] In sone embodiments, the step of transmiliing comprises transmitting a radio frequency signal.

10020] In some embocLmerts, the step at transmitting comprises transmitting an infrared signal.

10021] In some embodiments, the step of transmitting comprises transmitting an infrared signal from an erray of one or more infrared emitters.

[0022] In some embodimerts the step oftransmlting comprises transmitting said infrared signal within a zone defined by a radiation pat-erA of each of said Infrared emitters.

100231 In some embodiments, the disinfectant dispenser is integrated with said wearable zone detector, the method further comprising sensing dispensing of disinfectant by way of a contact dosuro.

10024] In some embor&nients, the disinfectant dispenser i separate From the wearaMe zone detector, the method Further comprising steps of at said disinfectant dispenser, transmitting an indication of dispensing of disinfectant to said wearabte zone detector, and at said wearable zone detector, receiviri said indication of dispensing.

[0025] In some embodiments, the Iransmittin of said indication of dispensing of disinfectant is performed wirelessly.

[0026] In some embodiments1 the wireless transmitting of said indicaton of dispensing of disinfectant uses rarfin frequency, infrared or visible spectrLlm radiation, such as by the ue of light emitling diodes fLED'S) 01 (tie Nice.

[0027] in some enitodirnents, the receiving of said indication of dispensing, is performed by the infrared sensor of said zone sensor.

100281 In seine en-ibodiments, the indication of dispensing is an infrared signal distinguishable from said zone identifier signals.

[0029] A further aspect oFthe pEesent invention provides a system for encouraging compliance of hand hygiene. The system oornprises a disinfectant dispenser; a dispensing detector configured to detect operation ci said disinfectant dispenser; a controller in cnrnrriuntation with said dispensing detector; a wearbIe zcne sensor in communication with said controller; an alerting device in communication with said contFoller and zone identification transmitter configured to transmit a zone identification capable of detection by said zone sensor when said zone sensor is within a pedefined proximity to said zone ideiililicaiicn transmitter, wherein said system is configured to activate said alerting means responsive to said dispensing detector not sensing cperntion at said disinfectant dispenser within a first predelined time delay of said wearable zone sensor detecting a change of zorls [0030] En some embodiments, the system is configured to disable said alerting device responsive to said dispensing detector sensiig operation of said disinfectant dispenser.

j:ooaii In sortie embodiments, the disinfectant dispenser is integral with said wenrable zone sensor.

(0032] In some embodimenls, the disinfectant dispenser is separate from said wearable zone sensor.

[0033] In some embodiments, the disinfectantdispenser is mounted na stibslantially ttxed location and said dispensing detector is configured to transmit indicaUon of operation of said disinlectaril dispenser, wirelessly to said controller.

[0G34J Some embodiments further cnmprise a data memory in communication with said controller, wherein said controller is configured to tog Into said data memory, a zone identifier for a curreri ione associated with snd change oF zone.

[0035] In some embodiments the controlLer is contgured to log into said data memory, a ione-change tine associaled with said change otzune. responsive to said change of zone.

(0036] In some embodiments, the controller is contigued to log into said data memory, a disinfectant dispen5er operation time responsive to sensing operalion of said disinfectant dispenser (0037i Some embodiments further comprise a plurality of zone identification transmitters, each confEgurect to transmit a unique zone identification.

100381 lii some embodiments, the nne identification transmitter is configured to communicate with said wearable zone sensor via a wireless s[nal.

(0039] In some embodiments, the wireless signal is an infrared signsl (0040) In some embodimen(s, each zone identifleution transmitter comprises an array of one or more Infrared erntters [00413 In some embodiments, each infrared emitter is configured to emit radiation in a predetined zone.

[0042] In some embodiments1 the predetinod zone is determined by a sheld on or around the PR transmitter having a predetined shape.

[00433 n some embodimeris, the predefined shape is conical, [00441 n some embodiments, the predefined shape is a fraction of a cone.

[0045] In some embedirrenis, the wireless signal is an ultrasonic signal [0046] In some ernbcdirrents, the wireless signal isa radio frequency signal.

[0047] Some enhodimerits further comprise a communication interface conligured to interlace with a central computer to permit transfer of said logged information Irom said data memory to said central computer, and wherein said central computer is configured to process said downloaded data to provide indications of hand hygiene cempiance.

[00481 Some erntjodirrents further comprise a docking station comprising a plurality of said communication interfaces configured to accommodate a plurality of wearable zone sensors.

OO49] In surnu embodiments, the system is configured to permit anonymous check out ant check in olsald wearable zone sensors, wherein each said wearable zone sensor comprises a unique identifier.

10050] In some embodiments, the processed downloaded dab is retrievable anonymously using said unique zone sensor idonti1er, [0051] In some erTtbodinlents, the processed data fur a predefined group or zone sensors is retrievable collectively.

[0052] In some embodiments, the system is conligtired to permit chock out and check in ol said wearable zone sensors using a user identifier and wherein said system logs said user identilier [0053] In some embodiments the system logs said user identifier in said data memory.

f00541 In some embodiments, the first predefined time delay is a funcliur of zone type as determined from saId zone identification.

[0055] In some embodiments, the zone idenUication comprises a uniclue number and wherein said zone iclentilicatiori Lransniitter is configured to transmit said zone identification as a coded sequence of pulses.

10056] In some embodiments, the coded sequence ot pulses coniprises an integrity check.

100571 In some embodiments, the zone identitication transmitter is configured In adapi the output level of said transmitted ended pulses responsive to an ambient radiation level.

100581 In some embodiments, the aerting device is configured to provide an audible signal.

[0059] In same embodiments, the alerting device i configured to provide a vibrating signal.

[0050] In some embodiments, the alerting dewice is configured to provide a visual signal, or one or more signals including visual, vibratory, auditory and the 1il'e.

[0061] In some embodiments, responsive to connection of the communiation interface, the controller initiates downloarfng of the logged information.

[0062] In some embodiments, responsive to hand wash dispenser action, the controller resets a first preset timer; resets a second preset timer; resets a Ihird preset timer: and disables alert it active.

(0063] In one aapecl at the invention a wearabc tag or device is worn by a caregiver or other user in a hospital or other care facility. The wearable tag can detect and log when the care9iver enters or passes through predefined zones and can log when the caregiver sanitizes his hands by detecting activaticn of a disperisirij unit. The dspeusing units can be integral In the wearable unit or alternatively can be fixed &spensing units in which case the dispensing unit can transmit indication of the activation of the dispansing unit. Cn one preteted embodiment the zones are defined by arrays of infrared (IR) transmitters. The arrays comprise one or more P emitters with associated culIimatorsIenses/shieIds to clearly detine a zone. The IR emitters in each zone are controlled by a zone transmitter which modulates the output of the emitters to produce a unique zone identifier.

100641 In some embodEments the step of starting a Iirst timer is responsive to sensing dispensing of disinfectant.

S

[0065] In some embodiments, responsive to connection of a data interlace, the controller initiates down load of data to a central computer.

(0066] In some embodiments, responsive to disinfectant dispensing action the controller resets a first preset timer; reset a second present timer; arid resets a third preset timer; and thsables the alerting device it active.

[0067j Another aspect of the present invention provides a wearable smart zone sensor configured to be worn by a user. The smart zone sensor comprises: a zone detector conilgured to detect a wireless zone identifier signal; a controller in communication with said zone detector; a data memory in communication with said controller: a dispenser activation detector in communication with said controller; and an alerting device in communication with said controller icr alerting the user, wherein the controller is configured b: decode a zone identifier from said zone identifier signal: determIne when saId smarl zone sensor enters a zone responsive to said zone identilier signal and store said zone identifier and time of enterirt in said data memory; determine when said smart zone sensor leaves a zone responsive to said zone identifier signal and store said zone identifier and time of leaving In sold data memory determine when disperser activation occurs responsive to said dispenser activation deteotor and store time of dispenser activation in said data memory; and alert said user when a hand cleansing operation is required.

[00681 Some embodiments further comprise art inlerface (a lsansunitting to an uxternat computer, the data stored in said data memory.

[0069] Some embodiments further comprise a housing configured as a user iderlitication card.

100701 Some embodiments further comprise a disperser for hand cleansing product wherein said dispensor activation detector is configured to detect dispensing of said hand cleaning product.

[0071J In some ernhcdimerts, the dispenser is coliocated in said housing with said smart zone sensor.

100721 Some embodiments further cornprisB a housing for enclosing said smarl zone sensor, wherein said housing is configured for attachment to lanyaril P0731 Some embodiments further comprise an arm pivotafly oornected to said housing.

wherein said arm houses said zone detector and is configured to mainlaiii said zone detector in spaced reationship from said user when said arm is in an operating position arid wherein said amni can be pivoted to a storage position, [0074] In some emntodi"ients (lie zone detector comprises an infrared (IR) sensor.

100751 In some embodiments the dispenser activation detectan is confiju red to receive a wireless signal from a fixed dispenser un[L [0076j In some embodiments the dispenser activation detector is configured to recekre n IR signal from said fi,ed dispenser unit.

(0077] In some embodiments the dispenser activation detector is confgured to receive a wireless sJgnsl from a portable dispenser unit.

100781 In some embodiments the dispenser activation detector is configured to receive a radio frequency (RF) signal tram said portable dispenser unt, 100791!n some embodiments the dispenser activation detector is configured for wired communication with a portable dispenser unit, said poaable dispenser unit configured for mounting on said lanyard.

[0080] Yet another aspect of the present invention provides a thect dispenser unit for dispensing a hand cleansing product. The lixed dispenser unit comprises: a cleansing product container; a cleansing product dispensertor dispensing said cleansing product from said cantainec; a wireess zone identilier signal transmitter tar transmitting a signal indicatIve of a dispenser activation and zone identifier for receipt by a smart zone sensor; a controller for encoding said zone identifier signal.

[0081] In some embodiments the fixed dispenser unit is configured for mounting on a wall.

[0D82] In some embodiments, the fixed dispenser unit is configured for mounting on a pylon.

L00S31 Some embodErnents further comprise a proximity sensor icr sensing proximity of a users hands to said disperser and wherein said controirer is turther configured to activate said cleansing product dispenser responsive to said proximity sensor sensing a users hands.

f00B4] In some embodiments, the fixed dispenser unit is configured for dispensing a viscous product.

L0085] In some embodiments, the cleansing product dispenser comprises a pump.

[OOBGJ In some embodiments, the wireless zone idenlitier signal transmitter comprises an infrared emitter.

1008?] In another aspect, there is provided a wearab!e monitoring unit, which comprises: a a dala transFer portion operable for receiving sensory data reporting a hygiene event from a hygiene detector, and zone data from a zone beacon, the zone data including zone tocation data andton ZOflh type daIa b. a memory portion including: L a first memory segment to store the sensory data; ii. a second memory aegment to store a group of hygiene status subroutines, each accordinc to a corresponding infection risk Ieval c a processor module configured to: 1. receive at least one zone data message from the 2cne beacon; 2. decode the zone data message to ident.iry a zone location data porlion and(or the zone type data porliori; 3 setect a hygiene status subroutine according to a zone type data portion and The infection risk level, or a correlation therebetween; 4. execute the s&ected hygiene status subruuline [0088) In some ertibodiments, the first stibrotitine indudes an instruction to issue an alert signal. The monitoring unit comprises a user alert portion (or issuing one or more hygiene alert signals tot an active attendant, wearing the monitoring unit, to carry out a hygiene event The user alert portion is responsive to the processar module to issue the alert signaL [OOfl9 In some embodiments, the user alert put-tion is operable to issie two or more different hygiene alert signals, the instruction incruding issuing a first of the hygiene alert signals.

100901 Some embodiments further comprise a user alert portion for issuing one or more hygIene alert signals For an active attendant, wearing the monitoring unit, to carry out a hygiene event, selected ones of the subroutines including instructions to issue a hygiene alert message, the user alert portion responsive to the hygiene alert message for issuing one or more hygiene alert signals to the user.

10091] In another aspect, there is provided a wearable monitoring unit comprising a data transter portion operable hr receiving sensory dale reporting a hygiene event from a hyjiene detector, and zone data from a zone beacon, the zone data including zone location data and/or zone type data. A user alert portion is provided for issuing one or micro hygiene alert signals for an active attendant, wearing the monitoring unit! to carry out a hygiene event A memory portion is also provided including first memory segment to store the sensuly data, a second memory segment to store a Qruup of hygiene status subroutines, oath according to a corresponding infection risk level, athtrd memory segment to store zone location data for a plurality otpredeterniined zone locations and/or zone type data for a plurality of predetermined zone types; and a fourth memory segment to index correlations between each of the hygiene status subroutines and one or more of tine predetermined zone locations and/or one or mere of the predetermined zone types. Also provided is a processor module which s configured to receive at least one zone data message from the zone beacon, decode the zone data message to idenbly the zone location data portion and/cr the zone type data portion; select a hygiene status subroutine according to an indexed correlation with the zone identity data portion and/cr the first zone type data portion; and execute the setected hygiene status subroutine.

100921 In another aspect, there is provided a wearable monitorLng unit. The wearsble mounting unit comprises a data transferportion operable in a first ptldSC for receiving sensory data reporting a hygne event from a hygiene detector, and zone data from a zone beacon, the zone data including zone location data and/orzone type data. The data transfer portion is operable in a second phase far transferring user identity data and/or activity history data between the monitoring unit and an external station. A memory portion is provided which includes a first memory segment to store the sensory data, a second memory segment to store a group of hygiene status subroutines. eath according to a corresponding infection risk level, a third memory segment to store zone location data for a plurality of predetermined zone locations andflor zone type data for a plurality at predetermined zone types, a tourth memory modure to index correlaIons between each of the hygiene status subroutines and one or more ofihe predetermined zone locations and/or one or more of the predetermined zone types, and a fifth memory segment to store the activity history data. A processor nodule is also provided and is configured to receive at least one tirst zone data message horn a first zone beacon, decode the lrst zone data message to identify a first zone location data portion and/or the first zone type data portion, select a first hygiene btatu subioutiuie according to an indexed correlation with the first zone location deta portion and/or the first zone type data portion; and execute the first subroutine.

(0093] Some embodrrents turther comprise a user alert portion for issuing one or more hygiene alert signals for an active attendant, wearing the monitorng unit, tn carry out a hygiene event. The first subroutine, in this ease, includes an instruction to issue sri alert signal. The user alert portion is responsive to the processor module to issue the alert signal.

f0004] In some ernbodirrients, the user alert pOrtIofl is operable to issue two or more different hygiene alert signals, In this case, the instruction includes issuing a first of Etie hygiene alert sigrials [0095] In some embodiments, the processor nodule is configured to receive at least one second zone data messaqe from a second zone beacon, decode the second zone dab message to identify a second zone location data portion aridior a second zone type data portion, select a second hygiene status subrcutine according to an indoxod correlation with the second zone location data portion and/cr the second zone type data portion, and execule the second subroutine.

[0096] Fri some embodiments, the second subroutine Includes an instruction to issue a second alert signal which is different from the first alert signal. Thu user alert portion, in this case, i responsive to the processor module to issuethe second alert signal.

(0097] In some embodinents, the second subroutine has a tower inleotFon risl< evel Ihan the first subroutine. The lower riak level is one not requiring an alort signal and the user alert portion is not operable to issue a second signal as a result of the second subroutine.

[00981 In another aspect, there is provided a system fur monitoring hand hygiene among a number of human attendants in a facility. The system includes a number of wearable monitoring devices, each to be worn by an active attendant. Each monitoring device includes a dala transfer portion operable in a first phase for receiving sensory data reporting a hygiene event trom a hygiene detector, and zone data from a zone beacon, the zone data including tone location data andlor zone type data. The data transfer portion is operable in a second phase for transferring user identity data and/or activity history data between the monitoring device and an external station. A user alert portion is provided and configured fer issuing one or more hygiene alert signals trw alerting the active attendant. A memory portion is also provided and configured to store the sensory data1 store a group of hygiene status subroutines, each according to a corresponding infection risk level, store a listing of predeterrriiried zone locations andlor a list of predeermlned zone types, store a listing of associations between each hygiene status subroutine and at least one predetermined zone location and/or at least one predetermined zone type, and store the activty history data. Also prc'dided is a monitoring processor module configured to receive at least one zone data message From a zone beacon, decode the zone data message to identify s zone location dati portion and/or a zone type data portion, select an assoeiation according lo the »=otie lesation data portion and/or the zone type dais portion1 select a hygiene staws subroutine according to the association, and execute the first subroutine.

[00991 In some embodiments, selected cries of the subroutines includes instructions to issue 2 hygiene alert message. The user alert portion is responsive lo the hygiene alert message for issuing ore or more hygiene olert signals to the user.

[ualtJOJ In Some enibodiments, the number of wearable ruoustoring devices include a first group oF wearable monitoring dev}css for a firsl jroup of human attendants. The memory portion in each of the first group at wearable monitoring devces is operable to store a first group of hygiene status subroutines and unique to he first group. A second group of wearable monitoring devices is also provided for a second group of human aliendanis. The memory portion in each of the second group of wearable monitoring devices is operable to store a second group of hygiene status subroulrnes and unique to the second group.

1001011 In another aspect, there is provided a wearable monitor unit for a hand hygiene monitoring system, wearable by an attendant ri a facility, The wearable monitor unit comprises a data transfer portion operable for nceiving sensory data of one or rliDre descriptors of acti/rty ot the attendant wearing the monitoring unIt. A monitor processor module Is provIded and configured to receive sensory data recording a number of repeated instances of a first current attendant activity, to generate a lirst series of current activity feature data sets For the first current attendant activity, generale a feature space data structure modeling the first series, receive sensory data recording a nuniber of repeated instances of a second current activity, to generate a second series of current activity feature data sets for the second current attendant activity, generate a feature space data structure modeling the second series; and associate each data structure with a corresponding hygiene risk level to form a number of assciciatioris.

A memory portion is provided and configured to store the feature space data structures for the first and second series and the associations.

j00102j In some embodiments, the memory portion is contigured to store a [1st of hygiene status subroutines, each according to a corresponding infection risk level.

çaoi 03] In some embodiments, The sensory data is processed or unprocessed sensory data.

[00104] Iii another aspect, there is provided a system for monitoring hand hygiene among a number of human attendants in a facility, comprising a number of wearable monitor units, each monitoring unit to be worn by one attendant-Each monitoring urt includes data Wansfer portion operable in a first phae for receiving sensory data reporting a hygtene event, sensory data of one or more descriptors of activity of the attendant wearing the monitoring unit and zone data The zone data includes zori location data and/or ions type data The data transfer portion is operable in a second phase For transferrtng user Identity data andlor activity history data between the monitoring unit aind an externat station. Also provided is s memory portion which is configured to store a plurality of feature space data structures, cacti for a predicted attendant activity, store a list otliygiene status subroutines, each according ton corresponding intection risk level and the aclivity history data-A monitor processor module is provided and configured to receive the sensory data to generate at least one current activity Feature data set for a corrert attendant activity, associate the current activity feature data set with the feature space data structures to generate a correlahon between the feature data set and one of the feature space data structures, select an infection risk level according to the correlation, select a hygiene status subroutine from the list of hygiene status subroutines according tame infection risk level.

and execute the selected hygiene status subrouFne.

(00105] In some embodiments, each monitoring unit further comprises an alerting portion for issuing one or more hygiene alert signals for the attendant to carry out a hygiene event. In this case, the solcctod hygiene subroutine Includes an instruction to the alerting portion for issuhrig one or more hygiene alert signals.

100106] In some embocJinients, the monitor processor module is configured to forni a group of identities for a corresponding number of successive current attendant acbvities, store the identities, predict a next attendant activity based on the stored Identities, seiect an infection risk ievel according to the next attendant activity; and carry out a corresponding hygiene status sLibroutine in advance of the next attendant activity based an Ihe selected infection risk level.

1001071 In some embodiments, the monitor processor configured to issue a hygiene alert signal according to the hygiene status subroutine.

L00101 Ii somo enibodinients, the data transfer portion is operable to receive the sensory data reporting a hygiene event, in the form o a signal from a dispenser worn by the attendant or fiord a dispenser not worn by the attendant.

[001 09] Some embodiments further comprise a dispenser which is operable for issuing a signal to the date transfer portion, with Pie signal carrying the sensory data reporting a hygiene event.

[00110] Ln some embodiments, the dispenser is worn by the attendant wearing the monitoring unit.

t°l" 1] Some embodiments further comprise one or more sensors for issuing a signal to the data transfer portion. Each signal carries the sensory data oforie or more desuiptors of activity of the attendant wearing the monitoring unit.

100112] In some embodiments, the sp.nsors include an accelerometer thermometer, microphone, eievation meter. pressure meter, motion sensor, global pcsitioning device, gyroscope, biood pressure monilor heart rate monitor, muscle activity monitor (electromyographic (FMG) sensors, Mechanooiyographic (MMG) sensors), skin conductance sensor.

(001 1] In some embodiments, one or mare of tho sensors include a sensor processor configured to generate one or more predetermined feature coordinates.

[00114] In some embodiments, the monitor processor is configure to generate the feature data set according to The one or more feature coordinates.

[00115] In sonic emtiodirnents, the hygiene event includes a hand wash disinfectant aclivatioft.

[00116] In some embodiments, the hygiene event includes a hand wash sink actialicn, a soap dispenseraclivation a towel activation, a glove dispenser activation and/or bower activation.

P0117] In some erribndinients, one or more of the sensors are configlu-ed to measure one or more signals of the attendant activity, inckiding linear acceleration, angular acceleration, temperature, air pressure, and/or sound as well as physiological signals such as heart rate, blood pressure, muscle activity, skin conductance of the attendant [001181 In some embodiments, the monitor processor employs one or more pattern recognition subroutines to generate the correlation, [00119] In some embodiments, one or more aitlie sensors measures angular or linear acceleration, speed, and/or distance the feature coordinates including mean, standard deviation, energy and/or axis correlation.

[00120] In some embodinients, one or lucre of the feature coordinates include one or more time domain features coordinates, ncludirig root mean square (RMS), integrated RMS, mean absolute value (MAy), mean absolute value slope (MAVSI.P), aero rxossing (ZC), waveform length, variance, nuniber ol'&ope sign changes and/cr amplitude histngrams.

[00121] In some embodiments, one or more of the feature coordinates Include one cr more frequency domain features coordinates including specraI representations of the signal, the spectral representations including Fast Fourier Transform (FFT) coefficients, autoregressive (AR) coefficients, and/or cepstral coefficients.

[00122J In some embodiments, ore of the feature coordinates include one or more lime-frequency features including shod-time Fourier transtorrn (STFT) coefficients, wavelet coefficients and waveet packet coefcicients (00123J In some entbodirnents the monitor processor is responsive to the sensorprocessors to receive a plurality of feature coordinates therefrom and to generate the feature data set.

100124] In some embodiments, the monitor processor is further configured to employ a diniensionality reduction stibroLitine to reduce the number of teatime coordinates in the plurality of received feature coordinates in the qcnerated feature data set.

100125] ri some embodiments, for the step to associate, the monitor processor is configured to employ a supervised and/or an uuiupervised classification subroutine, including Linear classifiers such as Lineal Discrimiriant Analysis. Decision Tables, Decision Trees C45), k-Nearest Neighbor, Support Vector Machines (SVM). Hidden Markov Models, Artificial Neural Networks, Fuzzy and neuro fuzzy classdier, and Clustering.

[001261 In some embodiments, [orthe step In associate, the monitor processor is coniçjured to employ a majority vote subroutine to resolve conflicts between a current feature data set and a corresponding feature space data structure [00127] In yet aiiothcr aspect, there is provided a system for monitoring hand hygiene among a number of human attendants in a facility, comprising a number of wearable monitor units. Each monitoring unit includes a data transfer portion operable in a first phase for receiving serisoTy data reperling a hygiene event sensory data of on or more descriptors ol acti\eity of the attendant wearing the monitoring unit, as well as zone data, in which the zone data includes zone location data and/or zone type data. The data transfer portion is operable in a second phase tar Iransferrin user identity data and(or activity history data between the monitoring unit and an external station. An alerting portion is provided tar issuing one or more hygiene alert siQuals for the attendant to carry out a hygiene event. A memory portion is provided and configured to store a plurality of vector space values for a predicted attendant activity; store a list of hygiene status subroutines, each according to a corresponding infection risk level; and the activity history data. A monitor processor module is provided and rontigured to receive the sensory data to assemble at least one current activity vector valuc for a current attendant activity, associate the current activity vector value with the vector space values to generate a corretation between the current activity vector vaue and one of the vector space values, select an infection risk level according to the correlation, select an atertsubroutinefrom the list of hygiene status subroutines according to the irrtectinn risk level arid execute The selected hygiene subroutine.

[00126] In another aspect, there is provided a system for monitoring hygiene compliance.

comprising a plurality of zone sensors for issuing zone data and a pluralily of wearable monitoring devices. ach we?rable monitoring device comprises a data transfer portion operable for receiving sensory data reporting a tiyyieiie event from a hygiene detecLor and zone data from a zone beacon in which case the zone data includes zone location data and/or zone type data. P. memory portion is also provided which includes first memory segment to store the sensory data a second memory segment to store a group of hygiene status subroutines, each according to a corresponding infection risk level. A processor module is provided which is conhigured to receive at least one zone data message Irorri the zone beacon decode the zone data message to identily a zone location data portion and/or the zone type data portion. seteci a hygiene status subroutine according to a zone type data portion and the infection risk level, or a correlation therebetween, and execute the selected hygiene status subroutine.

100129] In some embodiments, the plurality olwearable monitoring devices includes a first group of wearable monitoring devices for a first group of human attendants. The memory portinn in each of the Iirst group of wearable monitoring devices is operable to store a first group of hygiene status subroutines and unique to the first group. A second group of wearable monitoring devices is also provided br a second group of human attendants, The memory portion in each of the second group of wearable monitoring dcviccs is operable to store a second group of hygiene status subroutines and unique to the second group

BRIEF DESCRIPTION OF THE DRAWINGS

(00130] Further features and advantages of the present invention will become apparent from the fnllowing detailed description, taken in combination with the appended drawings, in which: [OUl3lJFlG. 1A isa breakaway perspective illusiration showing an embodiment of a smart zone sensor incorporating a wearable handwash dispenser of the present irivention [00132] FIG. lb is a breakaway perspective illustralian showing ariothsr embodiment of a wearable smait zone sensor of the present invention; [00133] FIG. 2A is a block diagram illustrating a wearable smart handwash dispenser in a system of the present invention; [00134JFlG. 28 is a block diagrani illustrating a wearable smart zone sensor in a system of the present invention; [00135] FIG. 3 is a breakaway perspective illustration showing emboolinient of a fixed handwash dispenser of the present invention; [00136] FIG. 4 is flowchart illustrating art embodiment of the present invention; 1001371 FIG. 5 is flowchart illustrating another embodiment otthe present invention; 1001381 FIG. fit,, 63,60 Utustrate various locations for wearing an embodiment of a wearable smart handwash dispenser; [00139] FIG. 7 is a plan view showing n exemplary layout elan embodiment the system of the present invention in a hospital setting; 100140] FIG. B is a perspective illustrafion of a zone defined by an embodiment of a zone array of the present invention; (00141J FIG. 9is Flowchart illustrating anotherombodiment of the preseiit invention; [00142J F10 lOis a perspective illustration eta lanyard -ID card embodiment olthe present invention; L00143] HG. 1 M and 113 illustrate a perspective view and a break-away perspective view respectively, of a lanyard -ID card with a wearable dispenser with RF ionimunication embodiment of the present invention.

[EJOI44IFIG. 12A and t2b illustrate a perspective view and a break-away perspeclive view respectively1 of a lanyard -wearable dispenser embodiment of the present invention; [001451 FIG 13A, 1 3ft 13C illustrale various locations forwearing an embodiment of a wea mUle siTlart Eiandwa9h dispenser; [001461 FIG. 14 illustrates a break-away perspective view of a fixed dispenser ernbcdiiiient of the present invention; [00147] FIG. 15A Ilustrates a perspecLive view of a pylon-mounted fixed dispenser of the present invention: [001481 PIG. 15S illustrates a perspective view oth wall-mounted fixed dispenser oFflie present invention [00149] FIG. 113 illustrates a perspective view of a bathroom zone embodiment of the present invention; [00150] FIG. 17 illustrntes a break-away perspective view of an embodiment of a zone controller of The present invention; (00151] FIG. IM Illustrates a perspective vew of an embodimeni of a collimator of the present invention; (00152] FIG. 18B illustrates a cross-sectional view of the collimator of FIG. 18k; t00153] FIG. 19 iilustretes exemplary embodirnenis of various shapes of collimators and Ihe resulting IR emission patterns; tODIM] FIG. 20 illustrates an exemplary array of collimators and the resultinq cubic zone they defin [001553 FiG. 21 is a perspective view of an area of an exemplary health care facility illusfratng various zone typos: and jOGISS] FIGs 22 22i and 23 to 28 are schematie views of other exemplified hygiene monitoflng systems and compononts thereat [00157] Ii will be noted that, throughout the appended drawings, [ike features are identified by like relerence numerals DETAILED DESCRIPIIOI1 OF THE PREFERRED EM6ODlMNT [00158] It shcu!d be understood that the invention is net l!mited in its noplication to the details of construction and the arrangement of components set forth in the following description or itlustrated in the drawings. The invention is capable of other embodiments and ci being practiced or of being carried out in various ways Also, it is to be understood that the phraseology arid terminology used herein is for the purpose of description and should not be regarded as limiting. The use of 1inckading," "comprising," or "having" and ariations thereof herein is meant to encompass the items Usred Ihereafter and equivalents thereof as well as additional items. Unless limited otherwise, the terms "connected," coupled, and mounted,' and variations thereof hemin are used broadly and encompass direct and indirect connections, couplhgs, and mountings. In addition, the terms "connected" and "coupled" and variations thereol are not restricted to physical or mechanical connections or couplirpa FurLhennore, arid as deacribod in subsequent paragraphs, the specific mechanical cortflgurations illustrated in the drawings are tntended to exemplify embodiments of the invention. However, other alternative mechanical configurations are possible which are considered to be within the teachings of the instant disclosure. Furthermore, unless otherwise indicated, the term "or" is to be considered inclusive.

L00159] Various embodiments of the present invention will now be described with relerence to the figures. FIG. 1A shows a breakaway perspective illustration of a wearable stuart di&nfectant dispenserassembly 10. The assemb!y comprises a smart zone sens& 12 which fits in external housing 14, along with dispenser cartridge 16. The dispenser cartridge 16 is a disposable cartridge for dispensing a hand san!flirig lotion or gel such as alcohol based sanitizing gels well knon in the aft The gel is dispensed by squeezing a resilient side wall of the cartridge 16 against external tiousini 1k The cartridge 16 can tie easily replaced as needed. In other embodiments, the cartride 16 is refitlable ard reusable. The zone sensor 12 has a signal detector 113, a control circuit 20, a dispensing sensor 22. and an alerting device 24. The detector IR will be discussed in its exemplified form as an infrared detector 18, though it may also be operable to recaive signals of other forms, such as ultrasonic signals. The infrared detector 16 can he an intelligent infrared detector integrated circuit ass well known in the art.

The control circuit uses a micro processorwith a real-lime clock or other suitable controller, The control clicuit 20 is connected to infrared detector 18 which is visible external to the external housing 14 so that the infrared detector 18 can receive infrared signals trom arrorig a plurality of zone transmitters 26 (see FIG.s 2, 7, 3) which can be set up in a hospital, or other caregiver environments or food handling environment where hand hygiene might be important to counteract cross contamination. The control circuit 20 is connected to dispensing sensor 22, which is shown here as a presswe.sensitive switch which is positioned so as to be able to sense the dispensing action of the cartridge when it is operated by the user. The alertrng device 24 can be an audible binier or sound generating device or a visual indicator such as a lamp or light emitting diode (I Fr)) or a vrbrator to provide an alerlirig signal to Ihe user without unduly distracting patients or attracting ettentiori, or a combination thereof. The control circuit 20 has a data memory 21 (see Ffl 2) for colrecting or logging data.

[OOI60]The assembly lOis operable in a ccjmniunication network which, in this etcample. is computer implemented and may be provided in a number of forms, by way of one or more software programs configured to run on one or more general purpose computers, such as a personal computer, or on a single custom built computer, such as programnied logic controller (PLC) which is dedicated to the function of the system olone A system controrling such a communication network may, alternatively, be executed on a more substantial coniputer mainframe. The general purpose computer may work within a network involving several general purpose computers, for exampte those sold under the trade names APPLE or IBM, or clones thereof, which are programmed with opemtrig systems known by the trade names WINDOWS, LINUX or other well known or lesser known equivalents of these. The systmn may involve pre-programnied software using a number of possible languages or a custom designed version of a programming software. The computer network may be include a wired local area network, or a wide area network such as the Internet, or a combination of the two, with or without Added security, auttientication protocots, or under "peer-tc-peer or client-sorvcr" or other networking architectures. The network may a'so he a wireless network or a conthination of wired and wireless networks. The wireless network may operate under frequencies such as those dubbed radio frequency' or' RF° using protocols suchi as the 802.11, TCP/IP, BLUE TOOTH and the like, or other wall known Internet, wireless, satellite or cell packet protocols.

While the assembly 10 collects location data from zone transmitters 26, the assembly may have INc ability to determine its location within Iha facility by use of other locating riieuiods. such as by global positioning system (GPS) protocols or variants or analogs thereof.

[001611 In another embodiment, the smart zone sensor 12 con be used independently of the wearable dispenser assembly 10. FIG. lB illustrates a breakaway perspective view showing a wearable smart zone sensor assembly 23 wherein a wearable housing 25 is conhigured to accept insertion of smart zone sensor 12 and further configured to accept a clip or lanyard or other suitable attachment means to allow a caregiver or other user to wear the assenibly 23. rn this embodiment the wearable smart zone sensor can operate in cooperation with a fixed or viall-mounted disinfectant dispenser 31 as shown in EtC. S. The wearable srnrt zone sensor assembly 23 is configuced to accept a wireless signal indicating a hand sanitizing operation froni an external disintectant dispenser such as the fixed disinfectant dispenser 31. The wireless signal can be, for example, one or more nra radio frequency signal, an ultrasonic signal, a visible spectrum radiation signal or, as in this particuar case, an infrared sinal using the infrared detector 18.

(0111 62]The wearable smart zone sensor assembly 23 can he conflgred as an uriuriyrrious device, with a device identifier discreetJy incorporated such that a user can readily determine the identity of the unit for later data tracking, but the device identifier is not easily visible to other people when it is worn by the nser. Alternatively, the wearable housing 25 can be combined with a user identification badge displaying the user's name 19 and(or photo 17 or other indicia as appropriate to the working environment. The wearable housing 25 can also incorporate rniagnetic stripes, bar codes or RFID tags, as is well known in the field of user identification badges.

[0D163] In general, the smart wearable disinfectant dispenser assembly 10, can detect zones that a user enters, such as can be defined around individual patient Leds, hDspital rooms or patient treatment areas, and can eoarci or lo the time of entering and leaving such zones as well as log the zone identilier. Thus, the assenthly lots operable to doted a change of zone, that is when the user moves 1mm one zone to another. The time or harr3 sar'iitizirig as delerinined by actrvation ot the disinteetant dispenser can also be logged.

[00164]The alerting device 24 can provide prompting to the user if he/she forgets to saniuze his/her hands when appropriate. If the user sanitizes his/her hands at appropriate times, then the aIertng signal is nol required and the user can avoid the annoyance of the alerting signal This feedback can provide a training or conditioning function which can help increase hand hygiene compliance among users. Another feedback mechanism can be revieMng a daily log of hand sartitiiFng activity correlated with a log of a users movement between zones. The wearable device otthe present nverltlon can be associated with a user ideritiller or atternaliely, can be used anonymousty. The user can benefit from the prompting óctions of the device and can else review the activity log anonymously by merely accessing logged data associaled with an identifier of the device used by the user [00166] rtG. 2A is a block diagram illustrating the smart wearable disinfectant dispenser assembly 10 of FIG. 1, in a system at the present invention, Controller 20 has data niernory 21 ar lugging data such as time of dispenser activations, and or entering 2nd leaving zones. The data memory 21 is an EEPROA for non-volate storage of data although other type of data memory known in the rI could be used as an alternativE The data memory 21 can store an identifier code unique to each individual unit, a record or log of the identity of each zone visited and the time at entering and lea'iing each zone, and a Fog of the time of dispensing actions or hand hygiene activity history. This data is stored for later downloading to a central conipulerfor later analysis. Temporary data such as hand disinfection status "flags of the caregiver (clean or dirty) wJlJ be storoci in Ihe controller 20 so Ihe unit will know whether Ft has been recently used to disinfect the wearer's hands (this time interval can be set in the software), or whether the wearer's hands have been disinlected since the previous zone was visited. These status flags may be used as a eondilion Iota hygiene status indication light or signal that itay be provided on or in association with the %vearable device, such as by way of the LED or similar signar indicator shown schematicafly at 25a in HG lB. Infrared zone identifier transmitters 26 define zones and are configured to emit pulse coded infrared signals to convey zone identifier information to the wearable unrt The coded signals incorporate check sums or other data integrity codes as is known iii the art, to provde reliabje detection reduce the possibility of false signals. Controller 20 is progranimeci to demodulate and decode the zone identity signals.

[00166] Fixed disinfectant dispenser assembly 31 can tie used iii conjunction with the smart wearable disinfectant dispenser 10, The fixed disinfectant disperser assembly 31 can be permanently wall mounted or attached to a patient bed or alternalively, be mounled on a stand or pedestal so as to be available tar the user of the smart wearable disinfectant dispenser 10 and to other persons, such as patients or visitors in a hospital. The user of the smartwearable disinfectant dispenser 10 can use the fixed disinlectnrit dispenser assembly SI for convenience or if the dispenser cartridge 13 is empty. The user can still benefit front the prompkkig and data logging features of the smart wearab]e disinfectant dispenser 10. When the user dispenses di&nlecting gel from the fixed dispenser 28 at fixed dispenser assembly 31, tflis action is sensed by dispensing sensor 30 and a coded signal is sent by infrared dispenser transmitler 32 to the iqfrarerj sensor i a of the wearable device. The coded signal is chstinguishable from zone iiieritifier signals. The signal is transmitted for a short period of time, for example, several seconds, to allow the-user to ensure the wearable unit captures the signal. Various feedback can be conveyed to the user. The fixed disperser can have a visual indicator such as an LED to indicate when The infrared dispenser transmitter 32 is transmitting. The controller 20 then decodes the infrared signal and treats this information similarly to receiving an indication from dispensing sensor 22. The user can thus receive credit tar disinfecting his/her hands. While the dispenser transniilter 32 is discussed as an infrared transmitter, other transmitters may also be used in some applications, such as ultrasonic or RF transmitters. II desired, tt'is dispensing sensor 22 and controller 20 may be configured to detect when a dispenser is empty.

[00167] If desired the controller may also be operable to decode, in addition tome zone identifier, one er more zone type identifiers in the zone identifier signal In this case, the alerting device may be operable lo issue one or more distinct typeset alerts to the user according lo the zone type identifier. The one or more ene type identiliers may. for instanceS include an identifier that the zone is an isolation region in light cii a predetermined communicable disease or condition, such as SEVERE ACUTE RESPIRATORY SYNDROME (SARS) or METHFCILLJN-RESISTANT STAPHYLOCOCCUS AUREUS (I1RSA). For instance, the zone transrtiit[ers 26 may be provided wiLh a switch function which controls one or more bits as needed in the tone identifier signal to allow staff to indicale lo the system that this particular zone is for an isolated patient, requiring special prornplinçj. The system may then provide a more urgent signal, such as a louder or recognizably different signal when leaving this zone and possibly when approaching a subsequent zone to reduce the probability of transmission by encouraging greater attention to the importance ci hand hygiene in this circumstance.

(001GB] b this end, the phiralily of zone identification tranamitlers riiay include a first group of one or more zone identification transmitters wtiich are configured to transmit a unique zone type identification, Each of the zone identifiers in the first group may thus include a switch function to adjust the zone type ideatification. The switch function may include a switch unit located at the zone identification transmitter, as shown schematically at 26a in figure 2/\, or be rerotely adjusted and/or activated by the central computer 36, as shown by the communication path schematically in dashed lines at 26b which may be a wired or wireless communication path.

(00169] The controller 20 is provided with communication interface 34. It Es shown here as a USB interface but persons skilled in the art will recognize that other interfaces could be used as well. The commvnicaflon interface 34 can connect to a connector incorporated in a docking station configured to accept one or more smart wearable disinfectant dispenser assemblies 10.

The docking station can store the wearable units when not in user recharge batteries within the wearable units and download the logged data from The data memory 21.

(00170] FIG. 2B illustrales a similar system to FIG. 2A but the wearable portion has a smart zune sensor witliciut the wearable dispenser portion such as housing 14 and cartridge IS. as shown in HG. I B. The dispensing detector or sensor 22 is not reciuired in this scenario and thus can be shielded by housing 25 or alterrativoty could be disabled by the firmware of controller 20 or alternatively smart zone sensor intended exclusively for use in housing 25 can be manufactured without the sensor ?2 The smart zone sensor could be inanulactured as a permanent cornponenl of housing 25. The wearable smart zone sensor 12 can be incorporated as pad of a user's ID badge or could be a plain unit th no easily vi&ble identfier information so that it could be used in an anonymous fashion [00171] FIG. 3 is a breakaway perspective view of the fixed disinfectant dispenser assembly 31 having a Fixed housing 20 sUitable for mounting on a wall, po!e, pedestal, hospital bed or other suitable location. The fixed housing 29 contains disinfectant dispenser 28, a dispensing sensor assembly 30 and infrared transmitter 32. The dispensing sensor assembly 30 comprises a sensor br sensing a dispensing action of disinfectant dispenser 28, and conlrol circuitry to generate a wiretess signal to be transmitted by infraed transmitter 32. The infrared trarismilter 32 comprises an infrared emitler and an infrared beam collimator or slnield to limit the radiation pattern of the infrared emitter in a region or zone proximate to the disinfectant dispenser assembly 31. In this rranoer a user disinfectin9 his/her hands using the disinfectant dispenser assembly 31 can present his/her wearable smart zone sensor 23 or wearable smart disinfectant dispenser 10 to the zone such that the zone sensor 12 is able to receRe the wireless signal indicating that he/she has dispensed disinfectant. Olherexamples cithe device 31 may not require the collimator (00172]The opei-aticn of an embodiment of the present invention will now be described with reference to FIG. 4. In operation, the wearable smart zone sensor 12 monItors and logs hand disinfectin activity, and entering and leaving zones. The method starts at 100. The controller 20 polls the infrared (IR) detector 16 at step 102. A zone identifier signal is detected by infrared detector IS and demodulated. An example ofa suitable »=one identilier signal is a pulsed code infrared Bigna on a 38 kilohertz carrier A 5 millisecond preamble pulse precedes Sri 8-bit binary pulse stream representing a zone identifier. This is followed by a second representation otthe zone identifier to act as a ohecic-surn and confirm the accuracy of the demodulated zone identifier, One example of a second representation is a puke stream representtng the zone ideruti!iei offset by a predefiried nuniber. Other check-sum techniques can be used, as is well known in the art, such as invorling the first pulse stream representation. An 8-bt identifier can distinguish up to 256 different zones. More bits can tie used for defining zone identifiers as required.

100173] Once a zone identifier has been determined. the controuer 20 pedortts a series of tests starting at 104 where the zone identifier is compared to a zone identilier' code which is associated with one or more Jixed disinfeclaLg dispensers. In one embodiment, one bit of the zone identifier binary representation, represents a disinfectant dispenser, thus iIthis bit is detected, the decision at step 104 is determined to be "yes" in which vase, at step 106, the controller 20 og the zone dentifier" identifying the dispenser. The process continues to step where the ctisiofecting action is logged wilh the associated time of day and date, lithe alerting device 24 is activated, it is resot. First tirrer TI, second timer T2 and third tImer 13 are also reset to begin counting down. Note that this functionality can Le used with either a wearabte smart disinfectant ithspenser assembly 10 or a wearable smart zone sensor assembly 23. lfdesired, a timer function may also be provided, to stan when the gel is dispensed and beep after a preset time (e.g. 15 set) to mark the end of a washing procedure, so that user knows how long they need to wash/rub for a particular sanitizing process.

(00114] First limer TI represents an 3cceptabIe period of time for a user to have disinfected his/her hands in advance of entering a zone, thus a nurse or healthcare worker can sanitize his/her hands while approaching a patieni's room. This mechanism can Then avoid triggering the alerting device 24 if the healthcare worker is conscientious and efficient The capability to avoid triggering the alerhng device can encourage healthcare workers and other users, to practice good hard hygiene and can possibly h&p in conditioning such behavior. An example of such a time period is 10 to 40 seconds. This time can be preset and could be configurable by an administrator using an exkrnal computer such as computer 36 in FIG,2A and 28.

[00175] Second timer 12 represents an acceptable amount of time for a healthcare worker to be inside a zone without sanitizing their hands. Even when restricted to a zone of a single patient, it is possible to cross contaminate the heatthcare worker's hands from ccming in contact with various bodily fluids, handling open waulids handling bedparis, etc. The 12 timer can be set to IC minutes fOr exatnplo.

[00176]Thircl timer 13 represents a time delay betore determining that a user has left a zone. A worker could briefly step oulside n zone while walking around a patient's bed for example. The wearable zone sensor could be briefly obscured while bending aver a patient or by movement of the user. T3 thus (forgivesh such irterrnittenl interruptions of a zone sicrial. the process then returns to the start of the flowchart as indicated by A' 112.

[OOlTTIStep 110 car also be reached by an inLeriupt signal 108 received from a directly connected dispensing sensor 22 of a wearable smart clisinfeclant dispenser assembly 10.

(00178] lEaf step 104, the zone ident[fier]s determined not to be a disinfectant dispenser "zone identifier" code, then the process continues to step 111 where (tie zone identifier is compared to an "old zone identiFier slorerl in nierriory 21. II tF cUrrent wne is the same as the old zone, then the user is slill ri the same zone and timer T2 is tested at step 124. 1112 has expired then al step 126, timer T2 is reset and The alerting device 24 is activated and the process returns to the start through 112-It the current zone is not the same as the previous zone (old zone) (hen at step 116, the zone identifier is tested to see ii it is a new zone. If yes, at step 118 the current (new) zone is logged in memo 21 along with the correeponding time-of-day arid date; the now (current) zone is stored as the old zone; and timer T2 is reset If the current zone is riot a new zone, then at step 128, the zone idenlifier is tested to determine ii not in any zone. If the user is in a recognizable zone, the process continues at the start via 112. If the user is not in a zone, then the process continues at step 130 where the old zone ts tested to see it it also was no zone" in which case tinier ISis tested at step 132 to see if the user has been outside of a zone sufficiently long to make a determinatiort that in fact the user is outside of a zone and not just obscuring the sensor temporarily. If it is determined that the user ties left a zone, then at step 134, the time and date ol caving the zone is logged in memory 21: timer 13 is reset; and the alerting device 24 is ecttvated. To avoid activating the alerfing device, the user should disinfect his/her hands within the time delay tnt 13. The process then returns to (he start via 112. With timer 12 reset iii step 1 18, the device queries at step 120 ii timer 11 has expired. It no, the device advances to step 112. If yes, timer TI is resal in step 122 and the device proceeds to step 112.

rooi 79] hat step 1301 the old zone was not no zone" then no zone" is a new condition arid the system can not yet determine lithe user is actually outside of a zone or is mereIi obscuring the sensor 10 temporarily in which case at step I 36, timer 13 is activated In tiack Ihe interval durir which its no definitive detem,ination can be made.

[U*'180] Another embodEment of the present invenlien wiLl now be described with reference to FiG. 5. In operation, an embodiment of the wearable smart zone sensor 12 implements Ihe process of FIG. 6. wFiicl't starts at step 200-At step 202, the controller 20 poiis the IR detector 18 to determine ila zone has been detected and if not loops back to step 202 to repeat the step unli a zone is detected, in which case the process advances to step 204 where the controller 20 stores the zone identifier (IC) in memcr9 21. The process continues to step 205 where the controller 70 checks it first timer TI has expired and if it has, alerting device 24 is activated at step 205. II timer TI has not yel expired, the process continues to step 210 where the controller tests ii the current detected zone is the same zone as the previous zone, that is, the user is still in the same zone. It it is, the second timer T2 is tested at step 212. PT timer 12 has not expired, the process returns to step 210. 1 tinier T2 has expired, at step 214, the alerting device is activated and the process returns to step 210. If at step 210, The controller determines that the user is not in the same zone, the process continues to step 216 where the current zone is tested to see if it is a new zone and if not. al step 218 the third timer 13 is tested to see it it has expired. If timer T3 has not expired, the process returns to step 210. [timer 13 has expired the alerting device 24 is activated a step 220 before the process returns to th'te start of the process at step 202. II at step 216, it is determined that the current zone is a new zone, the system determines at step 222, itthe disinfectant dispenser has been activated since the previous zone and if it has, the process returns to step 2%. The system can monitor integral wearable dispenser 16 or a lixed disperser 28 as prevwusty described, If at step 222, the disinfectant cflspenser has not boon activated since the previous zone, then at step 224, the user is alerted by alerting device 24, and the process returns to step 210.

[0U181J [IG.s 6A, eR, CC illustrate how the smart wearable disinfectant dispenser assembly 10 (lOa, lob, bc) can be worn by a user. The wearable smart zone sensor assembly 23 can be worn in a similar manner. The smart wearable disinfectant dispenser iDa is contigured to c!ip onto a chest pocket on the users clothing. The smart wearable drsintectarit dispenser assembly lOb mounts on the sleeve cUbe users clothing by a spring clip, a maçnetic pad with a cooperaIiri feirous rrieLal plate on the inside of the sleeve, with a pin the fabric ci the sleev& via a harness 38 worn ovcrr the sleeve or any other sLdtable means-The smart wearable disiritectant dispenser assembly lOc is mounted on a harness 40 worn on the users shoulder.

In general, it is advantageous to carry the wearable dispenser 10 higher on the user's body so as lobe easily accessible for dispensing The disinlecting gel, so as In not interfere with the user's other daily [asks such as to administer care to patients and to best position the infrared sensor 18 to receive infrared signals from overhead zone Identifier transmitters.

[00182J The lycxrt aizones will now be described with reference to FIG. 7 which illustrates a plan view of an exemplary layout of zones in a hospital selling 300. Zone 302 covers a doorway 304 to a hospita! ward or departmenL Zone 302 is defined by a zone beacon 312 which comprises an infrared emitter driven by a transmitter circuit to modulate the infrared radialiun In transmit a signal representing a cone identiFier. The emitter of zone beacon 312 can have a shield of conical shape to detJne a conical zone. Other shapes of shielils can be used to define different shaped zones as required. Zone 302 can be coded as a transitional zone and the firmware in the wearable zone sensor car be configured to require a disinfecting action only once while moving through the transitional zone 302, A zcne 306a can be defined around a patient bed 308 using a zone beacon array olemitters 310, which are described in more detail with reference to F1013. The patient bed zone 306 has clearty defined vertical boundaries which permits adjacent patient bed zone 30Gb to be located relatively close by without causing interference or over-lap of zones. A zone is also shown at 305c around a nearby patient bed.

[00183) With reference to FIG. 8, a zone 402 is defined by an embodiment eta zone beacon array 400 of the present inventiorn The zone beacon array (zone array) 400 includes an array of infiared emitlers, cacti having a shieid/cone/'collimator' 412 to clearly define the radiation pattcrn of each infrared emitter. The emitters end associated shields 412 are supported by a frame 410. This arranenietit facilitatos defining a zone having clearly defined boundaries with vertical walls (is thus possible to have different zones quite dose to one another without overlapping nd possibly causing interference. Tine frame 410 can accolumodate wiring Ia internonrect emitters from the same zone. A common trarsrnilter circuit (not shown) provirles the rnodulaited zone identifier signal to drive oath of the emitters as discussed previously. The Irame 410 can be lightweiuht and easly suspended from a ceiling and may be integrated into a suspended ceiling as desired. The transmitter ceo be reIativey low powered and be powered From an electrical power outlet with a power suppiy. A small battery can be supplEed to prcvide uninterruptible power ii required.

(00184] FIG. 9 is a simplified flowchart illustratin9 another embodiment of the present invention.

The (Iowctidlt describes the logic cii the wearable smart zone sensor/dispenser operation within the distributed hand hygiene compliance system. In this example, a number of software timers is used to adjust disinfection expiry intervals [or different clinical environments, where: -t is the tine of working with patient (1mb spent inside the zone); -t,, is the expiry tfrrie inside the zone; -t, is the explry Ume outside the zone; and -t, is the time of dispenser achvation.

(001851 The device is in sleep mode most of the tme and wakes up (or Iiiay otherwise be activated) periodically to check the presence cit the zone emitters at step 903 with the time of activation recorded at 905. Duration of the power saving intervals is contrnlled by a watchdog timer and defined by the maidmurn acceptable reaction Enie when the user/careqiver enters the zone. The portable unit can also be woken up by an interrupt signal resulting from dispenser aGtivation in the case of a directly connected dispenser. If the zone is detected at step 907 as determined at step 909, the device decodes, at step 915, the type of zone, by being responsive to different signals being emitted from different zones, not only to identify each of them uniquely, but also to classify them as between a full zone, a micro zone or a wall dispenser zone. The device checks, at step 917, to see if the detected zone is the same as the previous zone. The device checks at step 925 that the last disinfection occurred not earlier than the disinfection axpiry time Lexpi ciulside of the zone. Note that texpi is programmable and may vary for different applications. If disinfection was not performed or the time is already expired (step 919) the device prompts the caregiveral step 927 to activate dispenser. Wierithe device eaves the zone its disinfection status flag remains sd to clean for a certain pregranmable perrod ot time, so the caregiver is allowed to leave the zone temporarIy arid come back without being prompted for disinfection. In this situation if device detects the zone which is different from the previous one at slep 917 and dispenser was not activated between The zones (step 923 via step 921 to recnrd the zone ID and time of entering the zone) the disinfection status flag changes immediately issuing the prompting signal (step 027). If the zone is not detected at step 909, then the device querIes, t step 9l1, if the zone was detected before. If yes, then the device records zone ID and the time of leaving at step 913 and reverts hack to step 903. If, at step 0111 the zone i5 not detected, then the device reverts back to step 903.

[00186] Another embodiment of the present invention is illustrated ri FIG. 10 where 1000 is a wearable smart zone sensor. The controller I IC? (not shcwn) is contained wthin housing 1001 which is attached to a lanyard 1 003r at the type typically used to carry a user identilicabn (ED) card 1013. When this device sworn by a user the contrctler housing 1001 will be situated behind or near the user's head or lower down the body of the user. Arm 1005 is pivotally altached to housing 1001 end in an operating position it extends outwardly away from the user suci that infrared detector cm detecting means 1007, or in other words an electronic eye, is clear of the users head and hair and is in a position to accept infrared signals from zone identifier signal transmitters. In this embodiment an alerting crevice 1009 such as a beeper is located adjacent to the pivot of arm 1005. A USB connector 1011 is available to cnnect that device to a reporting means such as an externat computer to download stored data. This embodiment can be used by users such as caregivers, patients. visitors in a healthcare tacility to prompt the user to sanitize his or her hands when moving from zone to zone. The user can use fixed handwash dispensers Of the present intention, mounted on walls near patient zones to sanitize hi Ihrr hinds. These fixed handwash dispensers can transmit infrared signals indicating that handwashing and was performed, which can be received by the wearable unit and logged.

(901 Bfl 19G. 1 IA arid 1 lB iVostrate a peispective view and a break-away perspective view respectively, of anotlierembodimentofawearable smartzone sensorwithin housing 1001 and is working in cooperation with a corresponding wearable dispenser unit 1103 including dispenser cartridge 1105 and having an RF or other communication link 1101 wFTh the wearable sniart zone sensor 1000. This embodiment works similarly to the embodiment ci FlG.10 with the added functionality of having the wearable hand sani&er dispenser 1103 coruvenreriliy available. The wearable hand sanitirer dspenser 1103 can sense a dispenser activation via switch 1115 and transmit this information by way ot an RI transmitter located on printed circuit board 1111 held wiLhin housing portions Ii 13a. 111 Sb. RE signat 1101 is received by logic board 1107 having an RF receiver. Thus handwash activity can be performed conveniently by the user and the activity can be logged.

[00188] FIG. 12A and t2B illustrate a perspcctive view and a break-away perspective view respectively, of anaiher embodiment of a wearable smart zone center similar to that of FIG.s 10 arid 11, but iii this case the wearable dispenser 1203 is attached to the lanyard 1003. This embodiment has the advantages of not requiring a clip in order to wear the wearable dispenser and of avoiding the casts and complexity of an RE transmitter circuit and receiver. isng instead a wire connection 1201 running through lanyard iooa and terminating at end region 1205 with a dispensing sensor 1207.

[00189] As an example of constn.jction details, the wearable unit in this system can be constructed using a PICI 8LF2550 microcontroller! a 24LC256 EEPROM for data storage, a DS1338 real time clock. comniunicating with nicracontrcler via 12C Interface, and a PNA4602 infrared detector. The short-range R link between the wireless wearabte gel dispenser and the wearable zone sensor can use an rIRXDO42O or MICRF21 1 based 433.92 MHz receiver.

01P0] The wearable electronic units and gel dispensers work in palr with each dispenser being equipped with a MAX1472 based bansniitter to inlorm corresponding electronic unit about dispenser activations-In this configuration the main functions of wearable eectranic unit are to demodulate and decade zone identity signals, record the real time of entering/leaving the zones and dispenser activations, provide prompting if ruqLired, store hand hygiene activity history as well as the detected codes of the zones, The hand disinfection status ifiags" of the caregiver (clean or dirty) are stored in the wearable unit so it knows whether it has been recently used to disinfect the wearer's hands (Ibis time interval can be set in the software), or wtietherme wearer's bands have been disinfected since the previous patient zone was visited.

Advantageously, this distributed system does not require a reaF-tirne central co-coordinator The data recorded by the wearable srnarl zone sensors units can be later downloaded to a PC via a USB inteuface for monitoring nd further analysis.

1001911 Furthermore, an indicaton such as alight or other signal unit may be provided integrally the wearable dispenser 1203a as shown in FIG. 12A, for example on the housing 1203, or elsewhere on housing 1113 in FIG I 2E, or separate therefrom, or with the lanyard 1003. or the badge shown at 1013, as an indicat!on of The status rag. This would permit, for instance, a patient in a patient zone to deterrrine lithe attending user has executed the required disinfection step before visiting the patient's zone in particular If the status signal is "red" for instance, it may give the patient a cue to remind the user to disinfect before proceeding further.

Alternatively, the patient niay see a green signal indicatinj that the user has indeed disinfected prior to the visit.

[001923F1G I 3A laB, 13C illustrate various locations for wearing the embodiments of FIGs 10, 11, 12. Note that infrared sensor 1007 on arm 1005 is exposed beyond the user's hair so as to have improved line-cf-sight to at least one infrared transmitter when the user is inside a one.

[001 3] FIG. 14 illuslrates a break-away perspective vew of an exemplary embodiment of a fixed pylon-niounted dispenser 1400 of the present invention. The fixed dispenser is mounted an pylon or pole 1401. Printed circuit board 1403 comprises controller Functions for encoding infrared zone identifier signals, for controlling and interlacing with proximity sensor (net shown), and for controlling a pump such as a peristaltic dtspenser pump assembly 1413 The fixed dispenser 1400 uses replaceable refill bag 1409 for providing the disinfecting gel held within housing portions 1405, 1407. The lousing portions 1405. 1407 are, in turn, mounted oui the poLe 1401 with a drip catch tray 1426 located below the outlet of tubing 1411. Tubing 1411 dispenses the disintecting gel from bag 1409 by squeezing action of rollera of peristaltic pump assembly 1413. The fixed dispenser 1400 uses electric power provided by four AA batteries 1415, or an alternative power supply may be used as desired. In operation when a user places his/her hands tinder the fixed dispenser 1400 the proximity sensor detects the placement of the hands and the printed circuit board (PCB) control circuit activates the dispensing pump assembly 1413 to dispense sanitizing gel. rue dispensing purrp assembly 4I3 can he programmed to thspense different amounts of gel, for example I ml of gel every second for up to four seconds. When a dispensing activation takes place, the PGB control circuit then generates a zone ID signal which travels through wires 1417 to IR emitter array as shown by dashed lnes at 1419 behind reflector 1421. This zone ID sJgnal is only transmitted for a short time and s coded to inform the users wearable smart zone sensor that a hand sanitizing operation has been performed. The logic of the controller of the wearable smart zone sensor will sense the zone ltD signal and when it decodes the zone ID as representing the dispensing actun, it wUl set ttie status flag to c!ean' and log the action in the memory. Thus the fixed dispenser creates a I!micro 7one where the zone ID signal is transmitted only briefly, following a dispensing action.

The zone boundaries 1423 are determined by the shape of reflector 142t [00194] FK3 I BA ilkistrates a perspective view of a pylon-mounted fixed dispenser of the present invention. The pylcns 1401 are set in bases 1429 to support the pylons. Retractable physical barrier ribbon 1427 can span ¶3elween pylons or between a pyloa and a wall to control pedestrian traffic, and can be used to direct persons to a convenientty located fixed a dispenser to encourage hand hygiene. This can be reinforced by appropriate signs. This arrangement can be useful for controlling hand hygiene compliance in wide hallways, for example, or to define and set ip lemporary zones.

(00195] FIG. 153 illustrates a perspective view of a wall-mounted fixed dispensor 1501 which is similar to the pylonmcunted fixed a dispenser except that it is configured to be mounted on a wall 1500, fOOl9Gl FIG. 16 ilLustrates a perspective view at a bathroom zone embodiment 1600 of the present invention. In this embodiment, fixed dispenser 1601 can be used to dispense liquid soap which can be used in conjunction with water from faucet 161J7 and sink 1605. The fixed dispenser 1601 is physically similar to wa1-mounted fixed dispenser 1501. Infrared emitters ThOSA, 1603B. 1 603C transmit a zone identifier signal which is encoded to provide identification of the zone type Thus when a user wearing a wearable smart zones sensor enters the bathroom zone the smart zone sensor logs the zone IdentifIer for the bathroom zone. Fixed dispenser 1 601 Es configured to transmit a modified zone identifier signal for a short duration upon dispenser activation. [his modified zone identifier signal is encoded to inform the smart zone sensor that a dispenser activation has occurred to allow the smart zone sensor to set the status flag to clnan and In log the activation in memory When the usor leaves the bathroom zone without a dispenser activation of either the Iixed soap dispenser 1601 or a wearable disinfectant dispenser, the smart zone sensorwill alert the user with a single long duration prompt. This is a controsted by the persistent prompt that the user receives from the smart zone sensorwhen the user enters a patient zone without proper hand cleansing activity. In other embodiments the tixed bathroom zone dispenser 1601 can he applied with disinfccting gel instead ol liquid scap other embodiments would provide dispensers Irir liquid soap and for disinfecting gel [001 97] FIG. 17 illustrates a break-away perspective view of an embodiment of a zone controller 1 700 of the present invention The zone controllers 1700 comprise a zone controller housing top 1701 and a printed drcL.ilt board controller 1703. The controller Is configured to transmit a zone identifier signal to tnfrared LEEE) emitters 1709 via wires 1707. Each infrared emitter is mounted ins collimator cone 1711 which has a dust cover 1713. to one embodiment the collimators are configured to rneuM cr1 T-bars of suspended ceilings by means of T-bar clip 1715 Other meunting arrangements for the light-weight collimator cones will be readily apparent 10 persons skilled in the art. In one embodiment the infrared emitters 1709 are connected in series in groups of six emitters, driven by the current source on printed circuit board controller 1703.

Ambient light sensor 1705 is used by controller 1703 to adjust the drive curreni to the infrared emitters 1109 in order to provide crisp boundaries of the infrared zone1 according to varying levels of ambient righting in the zone.

[001 98JAn entrance zone can be provided using zone contretler 1700, configured to transmit a zone identifier signal comprising a zone type identifier. An entrance zone can have different hand hygiene compliance requirements compared to a bathroom zone or a pahent zone. The wearable smart zone sensors can be programmed to recognize different zone types by decoding the zone type identif[erwithin the zone identifier signaL Different actiens can be taken and different timing parameters can be used by the wearable smart zones sensors responsive to the zone type. For example when the wearable smart zones sensor detecis an entrance zone. it can be programmed to produce a sinile long prompt 1 cleansing was not performed within the expiring time before entering the zone. When the user leaves the entrance zone and no other zone is detected within a predefined or programmbte time-A long prompt is issued The wearable smart zone sensor can he programmed not to prompt the user as long as the user reniains within the entrance zone. The wearable smart zone sensor can also be programmed not to prompt the user when passing through the entrance zone while traveling between patients it proper hygiene procedures were perrorrned between the patient zones.

[00199]An embodinientofa collimatorl7ll of the present invention is illustrated in FIG. ISA along with a corresponding cross-sectional view in FIG. ien The collimtot walls restrict the field of emission of the infrared LED as well as providing controlled scattering or the infrared emissions in order to provide even infrared light distribution across the held ci emission. The collimator 1711 is provided with keyhole slots 171 a to engage complementary pins, not shown, in the dust cover 1713.

[00200] FIG. 19 illustrates exemplary embodiments at various shapes of collimators and the resulting IR emission patterns. Thus, collimator 1903 provides a generally circular emission paltern 1 909, collImator ICOI provides a generally fan-shaped emission pattern 1907, collimator 1905 provides a generally seniicircular emission pattern 1911. These calhmator cones can be combined into an array mounted on a coiling, to define a cube-shaped zone ii3 for example with welt-defined boundaries as shown in FIG. 20. Olher shapes of zones having well-defined boundaries can be defined by using different arrays of collimator cones. Well defined boundaries are advantapeous when adjacent zones are in close proirnity such astor example and adjacent patient beds in a hospital ward.

00201]FlG. 21 is a perspective view of an area of an exemplary health care facility illustrating various zone types In this example and entrance zone 2101 is defined at the entrance of a hospital ward Patient zones 2103 are defined around patient beds. Bathroom zones 2105 can also be provided.

(002021 In some embodiments, zones include an array of 12 PR. eniitlers housed in specially designed white plastic Collimatnrs The geometry of the Collimalors is dutsen by the desired zone bounciQry, the distancc from the floor and their respective location in the array In a square 12 emitter array, three shapes were determined to be sufficient to provide a cubic zone oldetectuon with a granularity of 5-10cm. Most zone shapes can be defined by using the three shapes but acconirnodating a complex custom zone boundary might require custom collimatnr While theiR emdters provide effective zone boundaries or delineations, there may be other configurations that enable similar zone boundaries. Fur example, modules may be availablo which are one or two dimensional, that is are capable of emitting a signal around crover an area or along a line and which are capable otdrawirig patterns or lines using visible red semiconductor lasers, such as those which are used in virtual keyboards and laser levels.

1002031 Another example is shown in figure 22 which schematically Jlustrates a system 2000 employing a number of smart zone sensors, in this case referred to as a number of wearable mcnitorLrg units, one of which is shown at 2010. The monitoring unit 2010 iricrludos a data transfer portion 2012. which may be provided by one or more discrete data transfer units, sr.rch as lransmitters, receivers, transceivers! or data transfer ports such as R8232, USB, Biuelooth, 80211 and the like. The data transfer portion 2012 is operable for receiving sensory data reporting a hygiene event, in this case from a hygiene detector 2014! and zone data from one or more zone beacons shown at 2016, the zone data including zone location data and/or zone type data.

[00204]A user alert portion is provided at 2015 for issuing one or more hygiene alert signals For instructing an active attendant, wearing the monitoril14 unit, to carry out a hygiene event. A memory portion is provided at 2020 to store data for use during operation of the monitoring unit As shown ri figures 22, 23, the memory portion includes a first memory segment Ma to store the sensory data and a second memory segment Mb to store a group of hygiene status subroutines HS1, HS2, HSn, each according to a cur responding infection risk level LI, U, Ln. The hygiene status subroutines provide predetermined alert signals to the attendant wearing the unit depending on the risk leveL Thus, the memory portion 2020 may he a single memory chip or the like or may include more than one memory chip or other memory element, such as a hard drve, or the like.

[00205]A monitor processor is also provided at 2022 which is configured to receive at least one zone data message from one of the zone beacons 2016, to decode the zone data message to identify a zone location data portion ZI and! or the zone type data porliorl Zt, to select one of a number of available hygiene status subroutines HSI to HSui, aucordirig to a zone type data portion Zt and an infection risk level 1.1 to Ln, or a correlation Iherebetween. and then execute the selected hygiene status subroutine. Thus, the monitor processor may select one of the number of hygiene status subroutines based on a specific geographical localkon, such as a monitored zone around a hospital bed, as would be indicated by the zone location data portion alone, or alternatively on a general geographical location, 5uoh as in a hallway, as would be indicated by a zone type data portion, for instance in the absence of a one location type indicating a specific location in the hal!way There may be instances vhere the monitoring unit may select one of a number of available hygiene status subroutines HS1 to HSn, according to correlation between the zone type data portion Zt and the selected hygiene status subroutine, witiout an infection risk level. For instance, the zone type data portion may be an infection risk level.

[00206] In this example, the first subroutine HS1 includes an instruction to issue an alert signal end the user alert portion 2018 is responsive to the monitor processor issue the alert signaL [00207] Selected hygiene alert subroutines HSl to HSn include instructions to issue a hygiene alert message and the user alert portion is responsive lo the hygiene alert message from the monitor portion for issuing one or more hygiene alert signals to the user. In this case, the use alert portion 2010 may issue two or more different hygiene alert signals, on histructiori From the monitor processor.

[002081 As shown in figure 23 thIs means that the monitor processor may be configured, in the case of a first zone data message Urn, to decode the message to iderilily a first zone location data portion ZI and/or a first zone type data portion Zt and Then select a first hygiene status subroutine (such as subroutine HS1) according to an indexed correlation with the first zone location data portion and/or the first zone type data portion. Next, the monitor processor clay be configured, in the case ala second zone data message which is different from the firsL zone data massage, to decode the message to identify a second zone location data portion and/or a second zone type data portion and then select, and execute, a second hygiene status subroutine l-1S2 according Loan indexed correlation with the second zone location data portion and/or the second zone type data portion.

[002091 In this case, the first and ecvnd subroulines HS1 and H32 may apply to different infection risks. For instance, The second subroutine HS2 may have a lower infection risk level than the first subroutine I ISI and the lower risk level may not require 911 alert signal. In this case, the user alert portion will not issue a second signal as a result of the second subroutine.

On other hand, the second subroutine may have a higher infection risk level than the first subroutine and the higher risk level may include an escalated second alert signal when compared with the first alert signal.

L002101 If desired, the memory portIon 2020 may also include a third memory segment Mc Ic store zone location data 71 for a plurality of predelermined zone locations and/or zone type data for a plurality of prcdotcrniined zone types; zvid a fourth memory segment Md to index correlations between each of the hygiene status subroutines and one or more of the predetermined zone locations 21 and/cr one nr more of the predelermiried zone typos Zt. It may be useful, in this case, to associate each tocation in Ihe facility with a risk level.

O021 1111 desired, the data transfer portion may also be operable for transtening user identity data and(ur activity history data between the monitoring unit and an external statIon 2024. In this case the memory portion 2020 may be p2lrtitiohled or otherwise arranged to include a fifth memory segrnerl Me to store the activity history data.

(00212111 desired, the processor 2022 may also inctude, or Interact with, a time-ofday module 2023 to associate a user activfty wilh a particular time of day in which the activity is carried out.

For instance, a bath activity for a patient at noon in a busy ward on a weekday may require involve oreater risk to the patient and others in the facility, when compared with a bath activity that occurs in a quieter ward setting, For example after visiting hours on a Sunday e'ening. In this case, the monitor processor may receive a time-of-day signal tromtbe time-of-day monitor and make an edjustment to the risk Icvel normally associated with the activity question, thus changing the hygiene status protocol employed.

[00213] Figure 5 ijlustrales one example of a group of hygiene status subroutines, involving three timer& Other hygiene status subroutines may also be configured with one, two, three or more timers as desired, depending on tue circumstances. Several examples at hygiene status subroutines falling under the group shown in figure 5 fallow: EXAMPLE: SELECTION OF INFECTION? RISK LEVEL-DEPENDENT SUBROUTIWE UPON ENTRANCE TO A 1AONITORED ZONE WITH A pAtENT INFECTED WITH N1RSA [00214] Category: Emphasized prompting upon eaving an area 100215] Protocol: Providing care for individuals with MRSA places special emphasis on ensuring that caregivers comply with thorough measures for preventing the spread of the disease. This includes disposing J garments warn while in contact and/or proximity to the MRSA infected individual and hand disinfection upon exiting the patients areaS (00216]Details: 1. Caregiver walks into a monitored zone 2, Wearable unit receives data message from zone beacon 3, Wearable uni decodes data message to identify zene location and zone type 4, Wearable unit identities zone Focation and/ar zone type as having a high infection risk level due to the presence of MRSA 5. Wearable unI (processor module) selects a status subroutine with an enhanced ability to detect when the caregiver exits a zone (eliminating or reducing the time window currently provided before the wearable unit acknowledges a cirie exii) [002171 In this case, the third timer would be set to a time Ihat is appropriate for these circumstances of the patient Where the Third timer may be set alter minutes ri one lower risk level example, it may alternative be set attwo minutes under these circumstances.

EXAMPLE: SELECTION OF INFECTION RISK LEVEL-DEPENDENT SUBROUTINE UPON

ENTRANCE TO A MONITORED ZONE WITH A PATIENT WITH A COMPROMISED IMMUNE

SYäTEM LOO2lSJCateuory: Emphasized prompting while in an area [00219] Protocol: Providing care for imrnunocompromised individuals places special emphasis on ensuring that caregiers comply with thorough measures for preventing the contamination of the patient's area with pattiogeris from other zones. This includes hand disinfection upon entering the patent's area.

[00220] Detaila: I. Caregiverwaiks into a monitored zone 2. WerabIc uiiit receives data message from zone beacon 3. Wearable unit decodes data message to identify zone location and zone type 4 Wearable unit identifies zone location and/or zone type as having a high infection risk levet due to the presence of a person with a compromised immune system . Wearable unit (processor module) scfects a status sLibroutine with and enhanced ability In prompt the caregiwer while inside the zone (reducing the time window currerntty provided before the wearable unit emits a prompt while inside a zone).

[00221] In this case, the first timer would be set to a time that is appiopriate for these circumstances of the patient. Whore the first timer may be set at two minutes in one lower risk level example, it may alternative be set at Ia tct4O seconds under tinese circumstances.

EXAMPLE: SELECTION OF INFECTLON RISK LE VEL-DPENDENT AND TASK-

DEPENDENT SUBROUTINE UPON ENTRANCE TO A MONITORED ZONE WITH A PATIENT

WITH A COMPROMISED IMMUNE SYSTEM

U0222]Qgpr;Emphasized prompting whe in an area [00223J Protoco. F'roviding care for irnniunocompromised indkiiduals places special emphasis on ensuring that caregivers comply with thorough measures fur prevenfing the contamination of the patient's area with pathogens from other zones. This includes hand disinfection upon entering the patient's acea and lhrogh hand cleansing after assisttng in toilehng activities.

100224] Details: 1. Caregiver walks into a monitored zone 2. Wearable unit rAceivas data message from zone beacon 3. Wearable unit decodes data message to identify zone location and zone type 4. Wearable unit identifies lone location and/or zone type as hawing a high infeotion risk level de to Ihe presence cIa person With a compromised rmmune system 5. Wearable unit (processor module) selects a statns subroutine ith and enhanced ability to prompt the caregiver while inside the zone (reducing the time window currently prcvded beFore the wearable unit emits a prompt while inside a zone) and with the abihty to prompt after changing an incontinence pad.

100225] In this case, the second Limerwould be set to a time that is appropriate for these circumstaria of the patient. Where the second timer may be set at two minutes in one tower risk level example, it may alternative be set at 10 to 40 seconds under these circumstances.

(00226] Figure 22a ilusLrates the wearable monitoring units in two groups, a first group of wearabte monitoring devices Gi for a first group oF human attendants, and the memory portion in each of the first group of wearable monitoring devices being operable to store a first group at hygiene status subroutines and unique to the fifst group, and a second gcoip of wearable monitoring devices G2 for a second group of human attendants, the memory portion in each of the second group of wearable monitoring devices being operable to store a cecond group of hygiene status subroutines and unique to the second group.

[00227] Another example of the system 2000 is shown in figures 24, 25. In this case, the wearable monitor unit 2010 is capable of maktig relatively more intelligent decisions on when and if to issue an alert signal. This additional intelligence is provided by way of the monitor processor 2022 which is configured to predict, analyze andforforecastan activity by the attendant wearing the monitoring unit.

(002201 In this case, the data transfer portion 2012 is operable for receiving sensory data iron a number of sensors shown at 2026 issuIng signaI of one or more descriptors or features of an ec4ivty of the attendontwearing the monitoring unit The sensors in figure 24 are merely examples and may be provided in smaller housings as desired. Also provided are a number of feature space data structures stored in the memory portion 2020 which are formed to model a template activity oFThe attendant, based on past examples of the acti'ity. Each feature space data structure may thus model a single activity, or a group of activities involving certain common activity features. The leature space data structures rosy be based on a generic sampling of lest subjects by carrying out the activities in question, to establish a generic set of feature space data structures for a class of users of the monitoring or on a specific set of feature space data structures for a specific user of a specific monitoring unit and assembled through a trainFng mode, as discussed above. Also provided is an activily module Ac w,ich serves as a currenl activity identifier to allow for an authorized entity, be it a user of the monitoring unit, a Iechnican assisting the user, or a supervisory representative or function overseeing a particular function, to determine or verify that the monitoring processor has iii fact correctly identified an activity.

This activIty module may include an audio signal, sucti as a heap, or a synthesized or pre-recorded voice message, or a visua signal, such an LED, LCD or other illuniinatinq element, or the like, or a bank of LED's, each identifying a predetemiined activity, or an electronic signal to be relayed to an external station either for redirecting an audio or visual or for analyzing the signal for further action. In the latter case, the activity module Ac may thus communicate with the data transrer ponlion.

[00229J Thus, for one example of the IeachinQ mode as shown in figure 26, the monitor processor is configured to receive sensory data in the form of feature coordinates Fl, F2, F3, F4, Fn. from one or more sensors $1, S2, 33, 54, Sn, recordinq a number of repeated instances of a first current attendant activity, such as adrninistering a needle', generate a first series of current activity feature data sets 1A1. 1A2, 1A3, IAn, for the first current attendant activity: and then generate a feature space data strucluFe FSl modeling the fãrst series.

[00230] Then, for a second activity, such as geing to the bathroont', the monitor processor may receive sensory data recording a number of repeated instances of the second current activity, generate a second series of current activity feature data sets 2A1 2A2. 2A3, 2An, far the second current attendant activity and onerate a feature space data structure F32 modeling the second series.

[0D2311 The monitor processor then is configured to associate, or be instructed to associate, each data structure with a corresponding hygiene risk level to form a number of associations.

The monitor processor is thus contigure to repeal these steps for as many activities as needed.

[00232J The memory portion 2020 is thus provided with a sixth segment as shown a! Wf in figure 25 to store the feature space data structures for the first and second series and the associations, as wetI as other series and associations as desired.

[00233111) this example, the sensory data being recetved by the monitor processor may be processed or raw sensory data. tn other woids, the raw data may be received by the data transfer portion 2C12 as a feature coordinate 3nd as a direct output from a sensor element such as a terripersture giuge, in an integer format in this case. On the other hand, the processed sensor dab may be received by the data transfer from another processor which in turn receives raw, or unprocessed data from a sensor and performs one or more calculations or subroutines on the data to generate one or more festure coordinates.

[00234] The monitor processor 2022 is, in this example, configured to receive the sensory data to generate at least one current activity feature data set for a current attendant actMty, associate the current activity feature dala set with the feature space data structures to generate a correlation between the feature data set and one of the feature space data structures; select an infection risk level according to the correlation; elect a hygiene status subrouline Iroru the list ofhyene status subroutines according to the infeclion risK level; and execute the selected hygiene status subroutine.

1002351 In yet another variation, as shown in figure 26, the monitor processor is configured to form a group 01 identities Ii, 12,13, bra corresponding number of successive current attendant activities and then store the identities. The rrinnitor processor is then operable to predict a next attendant activity based on the stored identities The monitor processor is then operable to select an infection risk level according to the next attendant activity; and Ihereafter carry out a corresponding hygiene status subroutine in advance of the next attendant activity based on the selected infection risk level.

(0023G1 In this case, the sensors Si, 52, 83, 54, Sn are conhigured for issuing a signal to the ddtd transfer portion, with the signal carrying the sensory data of one o more descriptors of acIvity of the attendant wearing the monitoricg unit, fOO23lJThe sensors my include an accelerometer, thermometer, mrcmphone, elevation meter, pressure meter, motion sensor, global positioning device and/or a gyroscope Seine of the sensors may themselves incrude a sensor processor shown at Sp, SpZ, 5p3. 8p4, Spn, as shown in figure 25. which are themselves configured to gerietate one or room predetermined feature coordinates Fl, P2, P3, P4, Fn and the monitor processor is configured to generate the feature thta set 2ccord op to the one or more feature caordinales [00236]Fhe hygiene event may iricltsde a hand wash disinfectant activation, a hand wash sink acUvation, a soap dispenser activation, a towel activation, a glove dispenser activabon and/or blower activation among others. These are collectively identified by the external sensor Ax.

(00239] One or more of the sensors may measure one or more signals of, or re'ating to, the aliendant activity, including temperature and/or sound. One or more of the sensors may measure angular or linear acceleration, speed, position and/or distance Ihe feature coordinates inclucfng, but not limited to mean, standard deviation, energy and/or axis cOlTelation (00240] The sensor processor, for those sensors employng one, may be configured to carry out a range at programs or subroutines according to a range of alQorithms for the correlation step, based on hardware, firmware or software, irciuding ne or more pattern recognition subroutines.

[00241J One or niore of the feature coordincles may include one or more time domain features coordinates, including, but not limited Ic, Foot mean sqIIre RMS), integrated RMS, mean absolute value (MAV). mean absolute value slope (MAVSLP), zero crossing (ZC), aVe1orm length. variance, number of slope sign changes and/or amplitude histograms.

100242! One or more of the feature coordinates may also include one or more frequency domain features coordinates including, but tic' limited to, spectrat representations of the signal.

the spectral representations including Fast Fouler Transform (FF1) coefficients, autoregressive (AR) coefficients, and/or cepstral noefticiani s.

(0U243] The feature coardinales may also include one or more time-Frequency features including, but not limited to, short-lime Fourier transform (STFT) cciefficierils, wavelet coefficients and wavelet packet coefficients.

[002441 The monitor processor may also be configured to carry out a range ci programs or subroutines according to a range of algorithms for the correLation step, based on hardware, firmware or software, including erie or more pattern recognition subroutines. In this case, the monitor processor is responsive to the sensor processors Ic, receive a plurality of feature coordirates therefrom and to generate the feature data set.

1002451 The monitor ç'rocessor may be further configured to employ a dimensionality rerluctiori subroutine to reduce the number of feature coordinates in the plurality of received feature coordinates in the generated feature data set.

[00246) The monitor processor may also be configured to employ a supervised and/or an unsupervised classification subroutine hic!uding for eample -Linear classifiers such a Linear Discriminant Analysis,

-Decision Tables,

-Decisnn Trees (C4.S), -k-Nearest Neighbor, -Support Vector Machines (SVM), -Hidden Maikov Models, -Artificial Neural Networks, -Fuzrg and neuro fuzzy classifier, and -Clustering.

1002471 In some cases an association betwccn (he feature data set and the feature space data structures may be sufficiently unrecognizable, that a corretation is not possible, is unclear, or has a retatively low confidence intervaL In this case, the monitor prDcessnr may he configured to employ one or more a "majority votes -type subroutine or other subroutine to resolve contlicts between a current feature data set and a corresponding feature space data structure For instance, it may be that most but not all of the feature coordinates have a maich wdh corresponding sectors ri the feature space data structure, En which case those correlating fealure coordinates out vote" the feature coordinates without a correlation.

[00248] The feature coordinates collected by the monitor processor can also be considered coefficients for a vector, where the feature data eat ray also be consicered a teature vector and the feature space data structure may also be considered to be a feature vector spacc,.

[00249]Thjs, the monitor processor is capable ol storing feature space data sfructures which in one example can be in The torin of store a vector space values for a predicted attendant activity. The monitor processor may thus also be cunfigured to receive the sensory data to asserubte at least one current activity vector value tbr a current attendant activity and then to associate the current activity veclor value with the vector space values to generate a 5! correlation. In one instance, the correlation may be a malhenabcal match, within a predetermined confidence interval.

[00250] Relen ing to figure 27, the operation of the system 2000 is as follows. First, the processor receives a zone data signal and decodes the zone identity and zone type signa portions. The monitor processor also collects feature coordinate dala Irom the various sensors via thoir correspunding sensor processors to form the activity feature data set. Depending on the number of feature coordinates, the systeni may then employ a dimension reductuin procedi.rre as described above If desired the sensors may also send raw data to the monitor processor so that the monitor processor may calculate and extract the features therefrom. In this case, the sensors sending raw data may themselves not be required Lu have a puocessor.

[00251]The monitor processerthen asks if the system is being trained. This state may be established by a manual or electronic switch Function onboard the monitoring unit, such asttie switch mr4ttle shown at SW! as deployed by an attendant, by an assisting technician, by supervisory personnel, or by an automated server function through a wireless or wired communication link to the monitoring unit It the status of the switch function indicates yes, the feature data set tar the current activity is labeled, such as by 1A2 above arid the feature set is recorded in memory. With the feature data set labeled and stored, the monitor processor then asks it the training is finished. This would be indicated by a counter recording the number at instances of the formation of the data set for the current activity. The counter wourd be advanced by the storing of the data set in memory or by some other overt either in advance of.

(or following, the storing ci the data set in memory. The current counter value woutd then be compared with a test count value and, provided that the current counter value is less than the test count value the iriunitor pronessor would then advance to the collection step. It the current counter value equals the test count value, meaning that training is tinished, the monitor processor then advances to testing subroutine, which may include a number ci trial activities ore setuptore nuniberoipresetactivities toseehowthe monitoring isfunctioning. fthe system is not being rained, the monitor processor compares the feature data set with the feature space data structures stored in memory to lock for a correlation, resulting in identifying an activity.

[00252] The monitor processor then guerics if the aclivhy is the wrong activity. This is done by the monitor processor issuing, or instructing the issuance of, a query signal, via the identity rnndue loan authorized entity, as described above. The authorized er.tty then confirms if the activily is the wrong activity. If yes, a training routine is repeated, causrig the sysleni to advance In the colleclion step #. If no, the monitor processor (hen accesses the hygiene status subroLltine that corresponds to (he infection risk level for the identified activity arid executes the hygiene status subroutine which, depending on the subrouline, leads to a user alert. The monitor processor then waits for a signal recording a hygiene event.

[00253] The t'o examples of the system benefit from (he ability otthe hand wash monitor units to make intelligent decisions in order to reduce the number of hand washings' that would otherwise have to occurwithout the intelligence.

[00254] For instance it a nurse were In wash her hands each lime she enters and leaves a patient area, she may be hand washing a great many times a day. Clearly, success in hand washing (or other hygiene) compliance and cost controls rriay be e,iliaiiced when the monitoring unit is able to make liformed decisions about justwhen the hand washing has to occur.

[00255jTo achieve this, in erie example, the hand ash monitoring unit may taught so that it can make judgments about when to identify a hygiene event and, if so, by which alert, and, it so, for which hygiene mode or procedure (such as putting on, or taking oft, protective gloves) [Oô2StlTo this end, in one example, the hand wash monitoring unit includes The ability to record a number of local "attributes" and thus to obtain a signature for The attributes, and then to evaluate the signature, or group of signatures, over a predelermined time interval, to identify a predetermined regular activity.

1P0257]A regular activity might be attending a toilet with a patient, with the monitoring unit sensing a change in the orientation of the torso of (he user (La. that the user is bent over) and sensing the sound (i.e. of a flushing toilet). Another predetermined regular activity might be attending to a paent in bed (bent over, no echoes), or walking, running, eating, or doing tiling.

And in each event, the sensor would be in a posilion to assess if hand washing is needed thereafter and, if so, determine when the hand washing (or oP'ter hygiene procedure) should occur. The monitoring unit may then alert ttie user accordingly.

100258) The system may thus track not only the entrance irtlo a sensed zone but the departure from ol-ic zone and the arrival at another zone, by tracking two beacons In succession, thereby indicating threctiori.

[002591 A collection or suite of signature plots may then be assembted for each predetermined activity! each signature plot for each attrihute of the activity, or for the activity itselL These may then be loaded on the hand wash monitoring unit as "teniplate signatures. The hand wash monitoririq unit may then: I) collect dale tor each attribute from each sensor over a predetermined sensing period; ii) form a "current" signature for each attribute (or a composite "current" signature); and Ihen iii) compare the "current" signature with the stored signatures, such as by a statistical best fit analysis to match the signatures with any one of the stored signature sets to approximate or predict the current activity [00260] Once the hand wash monitoring unit has identified the activity, it may then consider what hygiene activity neecis to be undertaken.

[00261]Ot course, the activities carried out by people in the hygiene-monitored environment will vary with theirjob description A custodian wil have a dIfferent set of acLivities to a nurse, and in turn a doctor. Each hand wash monitoring unit may then be loaded, irdesired, with a different suite of signatures according to their role in the facility.

[00262] The zone beacons may then provide a number of geographical markers and patient kienlitiers or other ocalional identifiers that nay be relevant to selecting a hygiene protocol.

The tiand wash monltorin unit may then do the processing, all at the local level, reducing bandwidth in the internal network ofthe lacility in question that would otherwise be necessafl'. ii the processing were being done at a central ser'er.

1002631 The local processino capability of the Fiand wash monitoring unit gives it the capability to ask more questnns about its own environment and make more informed decisions on when (and indeed If) a user needs to wash hands, rather Ihan relying entirely or nearby none beacons to issue signals provithig he hand wash monitortng unit a useful, though relatively limited view of what's going on. Rather, the hand wash rrronLtoring unit looks to the zone beacons for location and type information to describe the speclic zone environment and to its own local nioh;le resources by Way of sensors Worn by the user and to cthet' external sensors, as necessary, as shown at Sx in figure 25, to assess a current activity and conditions arid then assess a hygiene protocol for the activity under those conditions. These other external sensors may include such things as a local video camera or microphone in a zone.

100264] With the benefit of local processing at the hard wash monitoring unit, the processinp requirements for the zone beacons are substantially reduced. They may operate on tdeir own, once programmed, and not be part of a central network. The zone beacons may also be provided with local switching to a!low the zone beacons to Lderitify the "type' ot zone. The switching may be provided at a switch location in the nionLtored zone, or be remotely actuated by a remote wireless switch located or accessible in the monitored zone.

(O026] The hand wash monitoring unit may then be updated or uploaded at the external station 2024 during or foVowirig a data dump stage if new protocols need to be added.

[00266] The sensors 2026 may inctude hybrid sensors to detect nursing activities.

Accelerometers may be used to detect linear eccelerehon oIthe movement a gyroscope to detect angular acceleration of the movernerfl, or a microphone to detect environmental sound related to performing activities. Other sensors may also be employed to obtain more information from the envrronment such as temperature, sir pressure, as well as physiological sensors to monitor such features as heart rate, blood pressure.

j00267] rach sensors capable at recording raw data from the environmeni and sends either the processed or raw data to the wearable monitoring unit. However1 in order to decrease the processing load on monitoring unit and decrease power consumption, it may be desirable to include a processing unit in each hybrid sensor and send the results therefrom to the monitoring uniL [00268] Each hybrid sensor may communicate with the monitoring unit ejther by way of a wired communication path (such as a tJSB-HJIJ class) or by a wireless communication path (such as the Bluetooth Class-2} II should be noted that Eluetocith Class-2 is a relatively low power wireless protocol and may be particularly desirable in healthcare settings.

Data procas sing [00269] Pattern recognition may be used to identify different nursing activities. Pattern recognition is a branch of machine learning whose goal is to classify patterns into a number of categories or classes The components ol a typicat patlern recognition protocol in ore example are shown in the figure 2 Serising [00270] Each hybrid sensor may be confiurccI to detect a different modality of nursing actMty such as linear and angular acceleration. temperature and sound Preprocessing: 100271] The signal quality may be entrnnced or example by using filters to remove noise anifor other unwanted signals from The original signet.

Feature Extraction: [002721 The wearable monitoring unit may thus be configured to extract dscrIminalory features from the signal. The extracted features thus may be used to define the feature space within which the different classifiers can be evahialed.

[0D273] In tetnis of acceleration signal, the following is a nonexhaustive list of features that may be employed: [00274] Mean: is the DC component of the acceleration data. This lealure is mostly used to detect the body posture. Electronic tilt sensors work based on this feature.

(00275] Standard Deviation: us used for discriminating the range of possible acceleration values, which differs among different activities.

1002761 Lnergy: Can be used to estimate the intensity of the activity.

t00277] Correlation among axis: Features that measure correlation or acceleration between axes can improve recognition of activities involving rnovemeiits of multiple body parts.

[00278] It should be noted that different &gnals may typically have different characteristics. For example, the characteristics of an acceleration signal may be different from those of a sound signal Therefore, the techniques employed for extracting discriminatory features from an acceleration signal may riot be effective for signal data from other sensors The following examples of features may he explored and extracted from different signals recorded from different sensors to improve the accuracy of the system -The accuracy of the system maybe iiwastigated by trial and error, [00279] Time domain features. These are extracted from the ternp&al representation oIthe signal. Ecamples include root mean square (RMS), integrated RMS, mean absolute value (MAV), mean absolute value slope (MAVSLP. zero crossing (ZC) waveform length, variance, number of slope sign changes and amplitude histograms (00280] Frequency domain feature& These features are derived tram a spectral representation of the signal, including such examples as the Fast Fourier Tiansluuun (FFT) coefficients, autoregressive (AR) coefficients, and cepstral ccc'fticients [00281] TIme-frequency features, The short-time Fourier transform (SIFT) coeFficients wavelet coefficients and wavelet paoket coefficients are exemplos of Features computed from a joint time and frequency signal representation.

Feature Projeclioc: 100282111 necessary dirnensionality reduction techniques may utUized, such as Principal Component Analysis (RCA). lobe able to preser-il the Features more efficiently to the classifier, Classification: (OO2B3JThe task eta classitier is to assign a category lea newly observed feature.

Classifictions uf new objects n this exaniple each attendant activity, such as a prescribed nursng activity) are based on a set of prevoLtsly observed patterns whose true class is aresdy known, This set is known as tha training set. A classifier uses the training set to divide the exlracted features tile different classes.

1002841 A wide range of supervised ancHor unsupervised algorithms, from simple Bayssian classifers to complex and powerlul neural networks, may be used for classification. such as: Linear classifiers such as Linear Discriminant Analysis.

Decision Tables,

Deeision Trees (C4.5).

k-Nearest Neighbor, Support Vector Machines (SVM), Hidden Markov Models, Artificial NJeura Nelworks, Fuzzy and rieuro fuzzy classilier, sad Clustenng.

Post-processing [002851 A post-processor may be employed to use the output of the classifier to decide the Output Junction of the terminal device. The post-processor may improve system performance For exampLe, a technique called majority cto can be used to increase the classification accuracy. In this technLque, the output of each classifier is considered and the final decision is made vhen most classifiers agreed on a certain decision.

(002861 For example, it the accelerometers, and gyroscope classifiers (2 out of 3 otassifiers) decided that the curr&nt nursing activity is tahing blood pressure' but the sotnd classifier (1 out of 3 classifier) is showing the curreni nursing actIvity as inserting an IV, the majority vote among These 3 classifiers, would claim the current nursing activity as taking blood pressure".

[002873 The ability to predict the Rext nursing activity: The hand wash monitoring unit may log the history of the performed nursing activities and theii corresponding hygiene events.

Numerous mathematical and statistical algorithms are availab!e to help the monitoring unit learn from the sequence/pattern of the past nursing activities and let it predict the next coming nursing activities with acceptable accuracy. Examples of such algorithms include, but are not limited to.

Markov Models. Hidden Marknv Models, Funy systems. Neuro Fuzzy systems, and Artificial Neural Networks. For instance, if the monitoring unit recognizes that a current activity involves picking up a bed pan. the system may be able to identLly that the next activity will involve installing the bed par tar use. In another example, the system may recognize a Current activity as being pre-aseptic procedure! such as accessing a syringe out of a storage compartment or such as transporting a medication cart to monitored zone, thus indicative of an aseptic activity soon to follow and requiring hand washing before hand.

[00288] The entire subject matter of each of the References cited below is incorporated herein by reference: [I] S. S. Thies, P. Tresadern, L. Kenney, 0. Howard, J. 1. Goulermas, C. Srnilh and J. Rigby, "Comparison of linear acceterations from three measurement systems during reach & grasp"." Med/cat Engineering and Physics, vol. 20, pp. 67-972, November, 2007. 2007.

12) D. Rnetenbeg, C. T. M. Baten and P. H. Veltink, "Estimating Body Segment Orientation by Applying Inertial and Magnetic Sensing Near Ferromagnetic Materials' (FEE Trans. Neum! SysL Rehabil Eng., vol. 15, pp. 469-471, September 2Q07. 2007.

F3] S. M. Kidder, I'. S. Abuzzahab Jr, G. F. Harris and J. E. Jainson, "A system [or the analysis otfoct and ankle kinematics during gait,' RePabiMatio, Engineering, IEEE Transactions on, vol.4, pp. 25-32, March 1996. 1996.

[4] 8, Henmi. K. Yonenobu, T. Masatcnii and K. Oda, "A biomechanical study of activities of daily living using neck and uppr limbs with an optical three-dimensional motion analysis system." Mod RheumaVoL vol 16, pp. 289-293, October 2006. 2006.

[5] S. S. Rae, E. L. Bontrager, J. K. Gionley, C. J. Newsam and J. Perry, "Three-dimensional kinematics of wheelchair propulsion,' Rehabilitation Engineering, IEEE Transacthrns on, vol.4, pp. 152-160, September 1996. 1996.

[6] L. Baa and S. Intille, Actfvity Recoyntion (mm User-Annotated AcceleratIon Data.

vol. 3001, BRLlN: SPRINGER-VERLAG 3ERLIN, 2034, pp I-IT [1J N. Ravi, N. Dandekar, P. Mysore and M. L Littrnan, "Activity recognition from accelerometer data," in 2005, [8] J. Lester, T. Choudhury and G. Buuriello, A Practical Approach to Recognizing Physical Activities," Pervasive Computing, ol. a96fl, pp. 1-16, 2006.

[9J A. Nguyen, ID. Moore and I. MoCowan, "Unsupervised Cluttering of Free-Living Human ActNities using Ambulatory Acceleronietry," ConL Pmc. IEEE Eng. Med. Blot.

Soe,, voL 1 pp. 4895-4898, 2007.

[10] ID. M. Karanlortis, M. B. Narayanan, M. Mathie, N. H. Lovell and P. 0. Ceiler, "Implementation of a real-time human movement classifier using a triaxial accelerometer for ambulatory monitoring," IEEE Transactions on Information TechnelogyTh Biomedicine, vol. ID, pp. 156-167, 01. 2006.

[ill S. Pirttikangas, K. Fulinami and 1. Nakajima. Feature Sefection and Activity Recognition from Wearable Sensors. voL 4230, BERLIN: SPRINGER-VERG BERLIN, 2006, pp. 516-527.

(12] P. Lukcwicz, J. Ward, H. Junker, M. Stager, G. Troster, A. Atrash and T. Starner, Recognizing Woiksliop Activity using Body Worn ftfticmpf?oncs and Accelerometers.

[13] D. Minnen, T. Starner, J. A. Ward, F. Lukowicz and G. Troster, "Recognizing and discovering human actions from on-body sensor data," in (20O5t 2005 iEEE lriternaticna/ Conference on MulUmedia Had Expo(Pp.4 Pp). Pisceta way, NJ: IEEE.

CD-POMpp.; 2005 iEEE International Con icronoc on Multimedia and Expo, 6-8 July 200A Amstertlarn, Netherlands. pp. 4.

L141 R. Ohmura, F. Naya, H. Norna arid K. Kogure, "3-pack: Abluetooth-based wearable sensing device for nursing activity recognitin,' ii Mre!ess Pe,vastve Computing, 2006 IsI international Symposium on, 2006, pp. 6.

1002U91 115] F. Naya. R. Ohmura. F. TakayanagL H. Name and K. Kogore. "Workers' routine acUvily recognition using body moverncnls and ocation information," in Wearable Computers, 2006 10th iEEE International Sympo.siura on, 2006, pp. lC-1 06.

[OO29] While the present invention has been deecribed for what are presently considered the preferred embodiments, the invention is not so limtted. To the contrary, the inventon is intended to cover various modifications and equivalent arrangerren{s included within the spirit arid scope of the appended claims. The scope of the following claims is to be accorded tlie broadest interpretation so as to encompass all such modifications and equivalent structures and functions.

1002011 The embodiment(s) of the invention described above is (are) intended to be exemplary only. The scope of tue invention is therefore intended In he limited solSy by the scope of the appended claims.

Claims

<claim-text>WE CLAIM: 1. A wearable monitoring unit comprising: a receiver operable for receiving zone data from a zone beacon; an alerting unit; a memory having stored thereon a group of hygiene status subroutines, each according to a corresponding infection risk level; and a processor module configured to: receive said zone data via said receiver; identify an infection risk level associated with said zone data; select a hygienc status subroutine according to said identified infection risk level; execute the selected hygiene status subroutine; and upon user non-compliance with said selected hygiene status subroutine, activate said alerting unit.</claim-text> <claim-text>2. The wearable monitoring unit of claim I, said zone data including a zone typo, said infection risk level identified from said zone type.</claim-text> <claim-text>3. The wearable monitoring unit of claim! or claim 2, said zone data including a zone location, said infection risk level identified hum said zonc location.</claim-text> <claim-text>4. Thewearablemonitoringunitofanyoneofclaitns ito 3, fizrtherconflguredtoreceive, via the receiver, hygiene event data from a hygiene event detcctoç and process same in determining user compliance with said selected hygiene status subroutine.</claim-text> <claim-text>5. The wearable monitoring unit as defined in any one of claims 1 to 4, the processor fbrther configured to: receive second zone data from a second zone beacon; identify a second infection risk level associated with said second zone data; select a second hygiene status subroutine from said stored hygiene status subroutines according to said second infection risk level; and execute said selected second hygiene status subroutine.</claim-text> <claim-text>6. The wearable monitoring unit a.s defined in claim 5, wherein the second subroutine includes an instruction to issue a distinct alert via said alcrting unit upon user non-compliance with said second subroutine.</claim-text> <claim-text>7. The wearable monitoring unit as defined in claim 6, wherein the second subroutine comprises either a lower infection risk level subroutine for which said distinct alert comprises a lowered alert or no alcrt, a same infection risk level subroutine for which said distinct a.lcrt comprises a same alert, or a higher infection risk level subroutine for which said distinct alert comprises an escalated alert.</claim-text> <claim-text>8. The wearable monitoring unit as defined in any one of claims 1 to 7, further comprising a time-of-day module for adjusting said identified infection risk level, and thus selection of said hygiene status subroutine, as a firnction of time of day.</claim-text> <claim-text>9. The wearable monitoring unit as defined in any one of claims ito 8, wherein said selected hygienc status subroutine comprises a timer for timing compliance of the user with said selected subroutine, a duration of said timer set as a function of said identified infection risk level.</claim-text> <claim-text>10. A system for monitoring hand hygiene among a number of human attendants in a facility, comprising: a zonc beacon mounted within respective zones of thc facility, each for transmitting zone data; and a number of wearable monitoring devices, as defined by any one of claims Ito 9, each to be worn by an active attendant.</claim-text> <claim-text>11. The system as defined in claim 1 [,the number of wearable monitoring devices including: a first group of wearable monitoring devices for a first group of human attendants, the memory in each of the first group of wearable monitoring devices being operable to store a first group of hygiene status subroutines unique to the first group; and a second group of wearable monitoring devices Sr a second group of human attendants, the memory in each of the second group of wearable monitoring devices being operable to store a second group of hygiene status subroutines unique to the second group.</claim-text>