Background The coronavirus disease (COVID-19) pandemic has affected healthcare workers (HCW) in their clinical practice. HCW were challenged with new guidelines and practices to protect themselves from occupational risks. We wished to observe if hand hygiene behavior by real-time measurement was related to the dynamic of the epidemic, and the type of patient being cared for in France. Methods This study used an automated hand hygiene recording system to measure HCW hand hygiene on entry to and exit from patient rooms throughout the COVID-19 pandemic. We analyzed the correlation between hand hygiene compliance and COVID-19 epidemiological data. Analysis of variance was performed to compare compliance rate during the different periods of the epidemic. Findings HCW hand hygiene rate on room entry decreased over time; on room exit, it increased by 13.73% during the first wave of COVID-19, decreased by 9.87% during the post-lockdown period, then rebounded by 2.82% during the second wave of the epidemic. Hand hygiene during patient care and hand hygiene on room exit had a positive relationship with the local COVID-19 epidemic; conversely, hand hygiene on room entry did not depend on the trend of the epidemic, nor on nursing of COVID-19 patients, and it decreased over time. Conclusion HCW modified their behaviors to face the risk propensity of the pandemic. However, to improve the poor compliance at room entry, reducing confusion between the hand hygiene recommendation and glove recommendation may be necessary; disinfection of gloving hands might solve this issue.

The proper implementation of hand hygiene at key moments during patient care is the most important means of preventing healthcare-associated infection. Although there are many programmes aimed at enhancing hand hygiene, the compliance of healthcare workers (HCWs) remains incredibly low. One limiting factor is the lack of standardized measures and reports of hand hygiene opportunities. Direct observational audits have reported the weaknesses in this field. We report here a radiofrequency identification-based real-time automated continuous recording system (MediHandTrace(®)) that permits the tracking of hand hygiene opportunities and the disinfection compliance of HCWs that we evaluated against video recordings as being accurate (99.02%), sensitive (95.65%) and specific (100%). The system can also provide information that is useful to understand HCW non-compliance and will allow the evaluation of future intervention studies.

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Healthcare-associated infection (HCAI) in hospitals mainly results from unsolved but well-identified causes such as hand hygiene, overuse of catheters, and to a lesser extent, the airborne transmission of infectious agents caused by the misuse of respiratory precautions. The aims of the Institut Hospitalo-Universitaire Méditerranée Infection are to develop new approaches to fight HCAIs. Among them, new technologies that allow for the traceability of care and good practices reminders have been developed concomitantly to an anthropological approach, facilitating acceptability by healthcare workers. While the automated continuous monitoring system is validated and commercially available, some other technologies are still under clinical evaluation or in the early development phase. Quorum sensing-based biotechnologies are developed with the aims to fight against wound colonization.

Highlights The number of COVID-19 cases in Marseille, France, peaked in March-April. Resurgence was observed in June-August. Patients in the two periods did not present marked age and sex differences. Markers of severity were less prevalent in the summer period A 10 times decrease in the lethality rate was observed in June-August.

At present, technology is almost inseparable from our daily lives. Currently, according to the online statistics portal, Statista, 5.28 billion people (67.95%) own a mobile device globally (Turner, 2018).Most paperwork is in the electronic form, particularly in the nursing and medical fields. Without this electronic paperwork, work seems complicated. A quick search in electronic database search engines reveals that the number of studies on technology in the medical field has increased exponentially. The demand for research in technology over the past decades has become more necessary, making the world more connected (Korhonen et al., 2015).Technology in health care has been used to assist daily clinical practice and clinical processes, such as electronic health records and health information technology. Recording mass data allows hospitals to develop efficient clinical workflows and facilitate decisionmaking processes to improve patient safety (DeMellow & Kim, 2018; eHealth, 2012;Yanamadala et al., 2016).In the field of infectious diseases, due to the increasing number of emerging diseases, innovative approaches are essential. In particular, during the pandemic of coronavirus disease (COVID-19), some innovative technologies have gained attention. Using automatic monitoring and detection in disease outbreaks, such as mobile devices, cloud computing, the Internet of things (IoT) and geographic

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