journal article·2025-07-30Open access

Optimization of Cleaning and Hygiene Processes in Healthcare Using Digital Technologies and Ensuring Quality Assurance with Blockchain

Semra Tebrizcik, Süleyman Ersöz, Elvan Duman, Adnan Aktepe, Ahmet Kürşad Türker

Applied Sciences· Volume 15· Issue 15

Abstract

Many hospitals still lack digital traceability in hygiene and cleaning management, leading to operational inefficiencies and inconsistent quality control. This study aims to establish cleaning and hygiene processes in healthcare services that are planned in accordance with standards, as well as to enhance the traceability and sustainability of these processes through digitalization. This study proposes a Hyperledger Fabric-based blockchain architecture to establish a reliable and transparent quality assurance system in process management. The proposed Quality Assurance Model utilizes digital technologies and IoT-based RFID devices to ensure the transparent and reliable monitoring of cleaning processes. Operational data related to cleaning processes are automatically recorded and secured using a decentralized blockchain infrastructure. The permissioned nature of Hyperledger Fabric provides a more secure solution compared to traditional data management systems in the healthcare sector while preserving data privacy. Additionally, the execute–order–validate mechanism supports effective data sharing among stakeholders, and consensus algorithms along with chaincode rules enhance the reliability of processes. A working prototype was implemented and validated using Hyperledger Caliper under resource-constrained cloud environments, confirming the system’s feasibility through over 100 TPS throughput and zero transaction failures. Through the proposed system, cleaning/hygiene processes in patient rooms are conducted securely, contributing to the improvement of quality standards in healthcare services.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Healthcare Systems and Public Health · Engineering Technology and Methodologies · Technology and Human Factors in Education and Health

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Industrial Engineering, Kirikkale University, Kirikkale 71450, Turkey

Department of Software Engineering, Burdur Mehmet Akif Ersoy University, Burdur 15200, Turkey

References (39)

Show source-provided references
1. Stoumpos, A.I., Kitsios, F., and Talias, M.A. (2023). Digital transformation in healthcare: Technology acceptance and its applications. Int. J. Environ. Res. Public Health, 20.10.3390/ijerph20043407 ↗
2. RFID in the healthcare supply chain: Usage and application10.1108/09526860910927961 ↗
3. On the Application of RFID Technology in the Hospital Fabric Cleaning Process10.1051/shsconf/202214401008 ↗
4. Feasibility of a real-time hand hygiene notification machine learning system in outpatient clinics10.1016/j.jhin.2018.04.004 ↗
5. An autonomous hand hygiene tracking sensor system for prevention of hospital associated infections10.1109/JSEN.2020.3041331 ↗
6. Sharma, A., Tomar, R., Chilamkurti, N., and Kim, B.-G. (2020). Blockchain Based Smart Contracts for Internet of Medical Things in e-Healthcare. Electronics, 9.10.3390/electronics9101609 ↗
7. RFID analytics for hospital ward management10.1007/s10696-015-9230-6 ↗
8. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use10.1086/644756 ↗
9. Ruan, K., Wu, Z., and Xu, Q. (2021). Smart cleaner: A new autonomous indoor disinfection robot for combating the covid-19 pandemic. Robotics, 10.10.3390/robotics10030087 ↗
10. Bal, M., and Abrishambaf, R. (2017, January 22–25). A system for monitoring hand hygiene compliance based-on Internet-of-Things. Proceedings of the 2017 IEEE International Conference on Industrial Technology (ICIT), Toronto, ON, Canada.10.1109/ICIT.2017.7915560 ↗
11. CDC, and ICAN (2019). Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings.
12. Bacterial hydrophilins promote pathogen desiccation tolerance10.1016/j.chom.2022.03.019 ↗
13. Colella, Y., Valente, A.S., Rossano, L., Trunfio, T.A., Fiorillo, A., and Improta, G. (2022). A fuzzy inference system for the assessment of indoor air quality in an operating room to prevent surgical site infection. Int. J. Environ. Res. Public Health, 19.10.3390/ijerph19063533 ↗
14. The feasibility of an automated monitoring system to improve nurses’ hand hygiene10.1016/j.ijmedinf.2011.04.002 ↗
15. Martinez Perez, M., Dafonte, C., and Gómez, Á. (2018). Traceability in patient healthcare through the integration of RFID technology in an ICU in a hospital. Sensors, 18.10.3390/s18051627 ↗
16. Al-Masri, E., and Hamdi, M. (2015). RFID-based approach for monitoring patient’s health inside hospitals. New Trends in Networking, Computing, E-Learning, Systems Sciences, and Engineering, Springer.10.1007/978-3-319-06764-3_78 ↗
17. An application to reduce patient complaints by digital monitoring of.cleaning control forms in a private hospital in İstanbul
18. Karimpour, N., Karaduman, B., Ural, A., Challenger, M., and Dagdeviren, O. (2019, January 18–20). IoT based hand hygiene compliance monitoring. Proceedings of the 2019 International Symposium on Networks, Computers and Communications (ISNCC), Istanbul, Turkey.10.1109/ISNCC.2019.8909151 ↗
19. Tamper-resistant mobile health using blockchain technology10.2196/mhealth.7938 ↗
20. Vora, J., Nayyar, A., Tanwar, S., Tyagi, S., Kumar, N., Obaidat, M.S., and Rodrigues, J.J. (2018, January 9–13). BHEEM: A blockchain-based framework for securing electronic health records. Proceedings of the 2018 IEEE Globecom Workshops (GC Wkshps), Abu Dhabi, United Arab Emirates.10.1109/GLOCOMW.2018.8644088 ↗
21. Rouhani, S., Butterworth, L., Simmons, A.D., Humphery, D.G., and Deters, R. (August, January 30). MediChainTM: A secure decentralized medical data asset management system. Proceedings of the 2018 IEEE International Conference on Internet of Things (iThings) and IEEE Green Computing and Communications (GreenCom) and IEEE Cyber, Physical and Social Computing (CPSCom) and IEEE Smart Data (SmartData), Halifax, NS, Canada.10.1109/Cybermatics_2018.2018.00258 ↗
22. Electronic health record authentication and authorization using Blockchain and QR codes10.1016/j.procs.2024.06.358 ↗
23. Jamil, F., Hang, L., Kim, K., and Kim, D. (2019). A novel medical blockchain model for drug supply chain integrity management in a smart hospital. Electronics, 8.10.3390/electronics8050505 ↗
24. Integration of artificial intelligence, blockchain, and wearable technology for chronic disease management: A new paradigm in smart healthcare10.1007/s11596-021-2485-0 ↗
25. A blockchain-machine learning ecosystem for IoT-Based remote health monitoring of diabetic patients10.1016/j.health.2024.100338 ↗
26. Ktari, J., Frikha, T., Ben Amor, N., Louraidh, L., Elmannai, H., and Hamdi, M. (2022). IoMT-based platform for E-health monitoring based on the blockchain. Electronics, 11.10.3390/electronics11152314 ↗
27. A blockchain based federated deep learning model for secured data transmission in healthcare Iot networks10.1016/j.measen.2024.101176 ↗
28. Alfakeeh, A.S., and Javed, M.A. (2023). Efficient Resource Allocation in Blockchain-Assisted Health Care Systems. Appl. Sci., 13.10.3390/app13179625 ↗
29. Shen, B., Guo, J., and Yang, Y. (2019). MedChain: Efficient healthcare data sharing via blockchain. Appl. Sci., 9.10.3390/app9061207 ↗
30. Mozumder, M.A.I., Armand, T.P.T., Imtiyaj Uddin, S.M., Athar, A., Sumon, R.I., Hussain, A., and Kim, H.-C. (2023). Metaverse for digital anti-aging healthcare: An overview of potential use cases based on artificial intelligence, blockchain, IoT technologies, its challenges, and future directions. Appl. Sci., 13.10.3390/app13085127 ↗
31. The case of HyperLedger Fabric as a blockchain solution for healthcare applications10.1016/j.bcra.2021.100012 ↗
32. Hyperledger fabric blockchain: Secure and efficient solution for electronic health records
33. Agbeyangi, A., Oki, O., and Mgidi, A. (2024). Blockchain in Healthcare: Implementing Hyperledger Fabric for Electronic Health Records at Frere Provincial Hospital. arXiv.
34. Prokofieva, M., and Miah, S.J. (2019). Blockchain in healthcare. Australas. J. Inf. Syst., 23.10.3127/ajis.v23i0.2203 ↗
35. Alowais, S.A., Alghamdi, S.S., Alsuhebany, N., Alqahtani, T., Alshaya, A.I., Almohareb, S.N., Aldairem, A., Alrashed, M., Bin Saleh, K., and Badreldin, H.A. (2023). Revolutionizing healthcare: The role of artificial intelligence in clinical practice. BMC Med. Educ., 23.10.1186/s12909-023-04698-z ↗
36. Evaluating access control security in permissioned blockchain systems using Hyperledger Fabric
37. Permissioned blockchain for healthcare record sharing
38. Smart contract–based access control for the Internet of Things10.1109/JIOT.2018.2847705 ↗
39. Security services using blockchains: A state of the art survey10.1109/COMST.2018.2863956 ↗