Overview and Purpose
Hand hygiene is a cornerstone of infection prevention, yet adherence remains uneven across settings. This quasi-experimental study in Colombia evaluated whether a brief, virtual reality (VR) training program could rapidly improve correct hand hygiene execution among two key groups: health care assistants (HCAs) and informal caregivers (ICs) of dependent patients. The goal was to determine immediate training effectiveness and the feasibility of implementing VR-based instruction in real-world clinics and home care environments.
Why VR for Hand Hygiene?
Traditional training often falls short in sustaining correct technique or translating knowledge into practice. Immersive VR offers active learning with real-time feedback, allowing learners to practice the complete handwashing sequence and receive immediate corrective cues. The program aligned with WHO’s Five Moments for Hand Hygiene and integrated a 5-step technique delivered through a brief, guided video and on-screen prompts in Spanish to fit the local training context.
Methods in Brief
The study used a one-group pre-post design conducted in seven private hospitals in Bogotá. A total of 140 HCAs and 170 ICs participated, with 94 HCAs and 121 ICs completing the post-training assessments. Trained observers evaluated correct execution (a pass/fail against five steps without omissions), error types, time spent washing, and knowledge via a five-item multiple-choice test. Training included an onboarding session and up to three 15-minute VR practice sessions, delivering immediate visual and audio feedback and showing a playback of performance for guidance.
Key Outcomes
- Correct hand hygiene: Pretraining, 26.6% of HCAs and 9.9% of ICs performed the technique correctly. Posttraining, this jumped to 97.9% (HCAs) and 95.9% (ICs).
- Time spent: Handwashing duration increased modestly from about 37–38 seconds to roughly 46–48 seconds, suggesting thorough execution rather than rushed practice.
- Errors: Common pretraining errors (fingertip coverage, thumb cleaning, and nail cleaning) dropped to near zero after VR training.
- Knowledge: Knowledge scores improved modestly, indicating the primary benefit lay in technique execution and habit formation.
- Acceptability: Most participants rated VR training as very useful or extremely useful for improving their hand hygiene practices.
<h2Implications for Practice
The results show that a brief VR-based hand hygiene program can yield large, immediate gains in correct technique among HCAs and ICs, with sustained reduction in common errors. The approach provides a scalable, time-efficient method to standardize technique across clinical and home care settings, complementing broader infection prevention bundles. While knowledge gains were modest, the strong improvement in execution supports the argument that VR is particularly well suited for skill aquisition and behavior change in infection control.
Feasibility and Next Steps
The study demonstrated high acceptability and safety, with no VR-related adverse events reported. Scheduling flexibility, especially for ICs who balance caregiving duties, emerged as a practical consideration. Upfront development costs are a consideration, but ongoing use can be cost-effective given the gains in hand hygiene performance. Future randomized controlled trials and longer-term follow-ups are needed to assess durability and impact on infection rates, as well as cost-effectiveness in diverse health care settings.
Conclusion
Active learning through VR-enabled practice can dramatically improve correct hand hygiene execution among both formal and informal caregivers in Colombia. The findings support incorporating VR-based hand hygiene training into infection prevention strategies, with potential benefits for patient safety and health care efficiency across settings.
