Evaluation of Hand Hygiene Technique in Uzbekistan: First Experience from Semmelweis Scanner-Based Digital Assessment in Educational Institutions

Background: Hand Hygiene (HH) plays a crucial role in preventing Hospital-Acquired Infections (HAIs), yet compliance and technique often remain inadequate. To our knowledge, this study is among the first large-scale Semmelweis Scanner-based evaluations of hand hygiene technique among both medical and non-medical students in Uzbekistan and the wider Central Asian region. Methods: A cross-sectional study was conducted between March 2024 and July 2025 at the Tashkent Medical Academy and the Tashkent State Technical University, resulting in 4191 data scans and 16,764 pictures analyzed. Hand surface coverage was evaluated using the Semmelweis digital monitoring system, which provides image-based feedback on insufficiently covered areas. Adequate performance was defined as achieving at least 95% hand surface coverage. Results: The findings showed that only 43.4% of hand hygiene measurements achieved the ≥95% hand coverage threshold, while 56.6% showed incomplete coverage. The sixth WHO-recommended step, i.e., rotational rubbing of the thumb and fingertips was identified as the most frequently missed moment. Significant variation was observed across faculties and departments, with bachelors achieving the highest success (n = 1012, 51.8%) and Ph.D. students reaching the lowest (18.4%). Conclusions: Hand hygiene technique among students in Uzbekistan is highly variable and frequently inadequate when evaluated using scanner-based digital assessment. The findings suggest that incomplete hand surface coverage, rather than the absence of sanitization attempts, is the principal challenge. Digital hand hygiene monitoring systems can provide an effective complementary tool for technique-focused education and can support infection prevention practices in both medical and non-medical training environments.

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