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Game-based Learning Applications: Hospital Hygiene

Handwashing Simulator – one of several game-based simulations available through AppClinic’s cutting-edge collection of study apps for healthcare and veterinary learners. To some general audiences, this product may seem a bit odd – surely everyone knows how to wash their hands by now, right? Those who work in various health-related occupations, though, would likely disagree – for they know just how vital following proper hand hygiene guidelines can be. In the U.S. alone, an estimated 80,000 deaths occur each year as a result of healthcare-associated infections (HAI), according to the World Health Organization (WHO). That’s roughly 200 deaths per day, a figure which becomes even more grim when you consider the impact of HAI in developing areas of the world with limited access to vital sanitation resources. Simply put, those in healthcare professions should care about washing their hands, and doing so properly.

A brief handwashing history, for the curious. The link between handwashing and the spread of microbes was established in the mid-1800s by Ignaz Semmelweis, who worked for one of two University of Vienna Allgemeine Krankenhaus (General Hospital) clinics. While working, Semmelweis noted that rates of maternal mortality were nearly double in one clinic compared to the other (16% in comparison to 7%). He similarly observed that hospital staff and students were simply not cleaning their hands before entering the delivery room – a misstep that may seem incredibly foolish to us today, but was commonplace only two centuries ago. Semmelweis hypothesized that the clinic’s increased mortality rate might be a result of unwanted particles transmitted via the hands of hospital employees, and therefore recommended that all doctors scrub their hands with a chlorinated lime solution before engaging in contact with each patients. As a result, the mortality rate in the most affected clinic plummeted to a mere 3%, remaining at similar levels for a long time thereafter – a revolutionary breakthrough that cemented Semmelweis’ reputation among medical historians as “the father of hand hygiene.”

But – you say – if the need for proper hand hygiene was established way back in 1847, why are we discussing this matter in 2018?

Today, the World Health Organization reports that there exists an estimated 1.4 million cases of HAI across the globe at any given time, though this figure is likely a gross underestimation due to lack of proper reporting. Despite the existence of formalized hand hygiene guidelines set by the Centers for Disease Control and Prevention (CDC), compliance often remains low, even in resource-rich settings. Contaminated hands make excellent vehicles for spreading microbes, including (but not limited to) the following:

  • Streptococcus pyogenes (Group A Strep)
  • Rotavirus
  • Staphylococcus aureus (including MRSA)
  • Streptococcus pyogenes (Group A Strep)
  • Vancomycin-resistant Enterococcus (VRE)
  • Klebsiella
  • Enterobacter
  • Pseudomonas
  • Clostridium difficile
  • Candida
  • Rotavirus
  • Adenovirus
  • Hepatitis A virus
  • Norovirus

Simply put, a combination of a lack of access to clean water, inadequate sanitary facilities, and a lack of general awareness of the importance of hand hygiene (particularly in hospitals and other healthcare facilities) make practicing proper handwashing techniques critical in the the fight against the spread of healthcare-associated infections. While there exist no shortage of text and video-based hand hygiene guides (seriously, pick your flavor: Gangnam Style parody? All About That Bass video remake? Michael Jackson’s Beat It?), much research has suggested that game-based instruction leads to improved engagement and performance among learners – hence the creation of a much-needed game-based hand hygiene solution: AppClinic’s Handwashing Simulator.

Handwashing Simulator screenshots

Perfect for healthcare students learning proper handwashing techniques or for professionals looking to practice their hygienic skills, Handwashing Simulator helps players master proper washing time lengths, techniques, and scrubbing methods via satisfying touch-based simulation. Developed by academics and available exclusively for iPad, the game makes an excellent study tool, test prep reference, or general guide to the basics of proper hospital hygiene. AppClinic's Handwashing Simulator is available now for iPad.


What strategies has your workplace implemented to encourage healthy hand hygiene? Have you or your colleagues had an opportunity to try a game-based healthcare simulation like Handwashing Simulator? We’d love to hear your stories – don’t hesitate to get in touch!

Note: This article first appeared on the Filament Games blog.

James LaPierre