An innovative app developed at the San Cecilio Clinical Hospital with the support of IBS. GRANADA improves hand hygiene in healthcare facilities.

Safe Hands 3.0, designed in collaboration with a Granada-based startup and supported by ibs.GRANADA, promotes the prevention of healthcare-associated infections.

Coinciding with the week of World Hand Hygiene Day, professionals and researchers at the San Cecilio University Clinical Hospital are presenting the new digital application, Manos Seguras 3.0, developed in collaboration with the Granada-based startup Health & Preventive Systems (H&P Systems) and with the support of ibs.Granada (Granada Biosanitary Research Institute). The tool is a direct result of the clinical field of public health to reduce healthcare-associated infections (HAIs), contributing to lower mortality and preventable hospital costs.

The project is the result of a public-private partnership that has resulted in several intellectual property registrations jointly held by the SAS (Andalusian Health Service) and H&P Systems, a subsidiary of BeeBit, along with the signing of a commercial exploitation license agreement, promoted through the ibs.GRANADA Innovation Unit.

For Indalecio Sánchez-Montesinos, the regional delegate for Health and Consumer Affairs in Granada, who chaired the presentation ceremony, "this tool represents the commitment of the Andalusian public health system to continuous improvement and useful innovation, serving professionals and patients." He also highlighted "the value of projects like Manos Seguras 3.0, which emerge from daily clinical work and become practical solutions with the potential to extend to the entire healthcare system."

MS 3.0 (Safe Hands 3.0) is a portable, multiplatform solution (app and web support) that goes beyond the WHO strategy to ensure hand hygiene compliance at the five key moments of healthcare, as it proposes a comprehensive vision of "safe hands," not just "clean" hands. The application is the result of prior research led by Preventive Medicine and Public Health, which also included the participation of the Dermatology, Information Technology, and Communications departments, reflecting its cross-cutting and collaborative approach.

Carmen Valero Ubierna, Head of Preventive Medicine and Public Health at Clínico San Cecilio, explains: “The Manos Seguras 3.0 project was born after the pandemic, when we observed that the indiscriminate use of gloves was displacing proper hand hygiene.” In this context, Dr. Valero adds: “We designed a strategy and measures focused on three areas: hand hygiene at the right time and in the right way, using gloves only when necessary, and caring for the skin on the hands of professionals. And we integrated this with professional information and communication systems to achieve rapid and effective implementation, which could also be exported to other centers.”

Features and results of the tool

Among the potential benefits of this digital tool, which fosters a culture of safe hands, are its ability to collect data in real time and generate immediate reports, in addition to personalizing training activities. Its ability to operate offline facilitates work on-site, improving traceability and response. It also includes the ability to access signage, videos, surveys, and more. It also has its own visual identity and a powerful communication design, which facilitates its integration into the daily operations of the centers.

Implemented as a pioneering tool starting in 2023 at the Clínico San Cecilio, the tool has already demonstrated very positive results. For example, its use has increased adherence to proper hand hygiene measures, reaching some thirty patient wards; training sessions have also increased more than fivefold, from 290 to more than 1.600 professionals between 2023 and 2024; and overall adherence to good hand hygiene practices has increased by 15%.

Origin of the APP

To manage compliance observations, training, and structural assessments in real time, a partnership was forged with H&P Systems, which gave rise to the app and its web platform. "We needed a portable tool that could be used offline and could generate immediate reports," says Valero Ubierna.

Valentín Pedrosa, CEO of H&P Systems, highlights the strategic value of the alliance: “After nine years in the startup world, I saw MS 3.0 as a unique opportunity to save on hospital costs and improve waiting lists. The application faithfully reproduces the clinical project and, after two years of commercial operation, has proven its effectiveness in more than 150 public healthcare facilities, including hospitals and health centers, with a satisfaction rate of over 90%.”

Since its implementation, MS 3.0 has enabled more than 20.000 annual observations to verify adherence to and compliance with good hand hygiene practices, in contrast to the audits limited to critical care units (ICUs, Infectious Disease wards, etc.) that were previously conducted.

This increase in surveillance activity has shown that a large part of hand hygiene noncompliance is due to improper glove use, which has made it easier to target training actions more precisely.

Results and scientific endorsement

Thanks to these initiatives, adherence to good hand hygiene practices has increased by 15% at Clínico San Cecilio and by an average of 12,3% at other external healthcare centers that have tested the app.

In economic terms, it is estimated that each center can save between €300.000 and €650.000 per year, with a very low investment cost. The project also has the endorsement of the Andalusian Society and the Spanish Society of Preventive Medicine and Public Health, and has been presented at national and interconference conferences.

Currently, preliminary approval has also been received from hospitals such as La Paz, the Marqués de Valdecilla University Hospital, the Arrixaca Hospital, the Príncipe de Asturias Hospital, and the Jiménez Díaz Foundation Hospital, among others, to carry out a multicenter study of an artificial intelligence engine for automated observations, pending the successful presentation and completion of the project at the San Cecilio University Clinical Hospital.

For Manuel Reyes, managing director of the San Cecilio Clinical Hospital, “innovation and knowledge generation are fundamental pillars of public healthcare. Initiatives like MS 3.0 are born from the needs identified in the clinical setting and demonstrate how our hospital, as a living laboratory, can pilot solutions that are then expanded to the entire healthcare network.” Reyes emphasizes that “this type of project reinforces our commitment to healthcare excellence and makes the San Cecilio Clinical Hospital a benchmark for the transfer of technology and best practices.”

Future development

H&P Systems is seeking public and private funding to continue developing new features for the app, to train an artificial intelligence engine that complements in-person observation, and to develop monitoring modules for multidrug-resistant organisms and potential IRAs, integrating this data with data from Manos Seguras 3.0.

Healthcare-Associated Infections

Healthcare-associated infections (HAIs) are infections that patients acquire during their stay in a healthcare facility and that were neither present nor incubating at the time of admission. These infections can affect any patient and are associated with medical procedures, invasive devices, or the hospital environment in general.

HAIs represent a major global public health problem, increasing morbidity and mortality, prolonging hospital stays, and generating high economic costs. According to data from the 2022-2023 Study on the Prevalence of Nosocomial Infections in Spain (EPINE), prepared by the Spanish Society of Preventive Medicine, Public Health, and Healthcare Management, HAIs are estimated to affect around 300.000 patients in Spain, almost 8% of those requiring hospitalization, with more than 6.000 attributable deaths.

Preventing HAIs is a priority for healthcare systems, and hand hygiene is one of the most effective and simple measures to reduce their incidence. Tools such as the Safe Hands 3.0 app are essential for improving adherence to hand hygiene practices and, consequently, reducing the occurrence of these infections.