Personal protective equipment (PPE) is critical for infection control in healthcare, protecting workers and patients from infection risks. The COVID-19 pandemic further highlighted the importance of correct PPE use, yet adherence to U.S. Centers for Disease Control and Prevention guidelines remains inconsistent. Continuous human monitoring of PPE adherence is impractical because it is labor-intensive and may expose observers to infection risk. Automated monitoring is a promising alternative, but reliable PPE assessment in clinical videos remains difficult due to occlusion and subtle differences between adherence levels. To address these challenges, we propose SAFE - Smart Adherence detection Framework for PPE, a cascaded computer vision system for real-time monitoring of PPE wearing status, including complete, incomplete, and absent cases, with a focus on gowns and masks. SAFE uses a two-stage design: Stage 1 detects gown status and localizes head regions, and Stage 2 classifies mask status from head crops. We evaluate SAFE on R2PPE, a ceiling-view trauma-room simulation dataset with dense PPE annotations and complex scenes. SAFE improves overall average precision from 0.48 to 0.67 and increases mask-class average precision by 0.33 compared to a baseline one-stage detector. We further validate SAFE across modern detector backbones, including transformer-based detectors, and on real-case trauma-room data using class-level and alarm-level criteria, improving class-level mask accuracy from 0.59 to 0.65 while maintaining a high alarm-level recall of 0.98. SAFE could enhance PPE monitoring with minimal human intervention, providing a scalable solution for improving infection control in healthcare settings.

OBJECTIVES: Human monitoring of personal protective equipment (PPE) adherence among healthcare providers has several limitations, including the need for additional personnel during staff shortages and decreased vigilance during prolonged tasks. To address these challenges, we developed an automated computer vision system for monitoring PPE adherence in healthcare settings. We assessed the system performance against human observers detecting nonadherence in a video surveillance experiment. MATERIALS AND METHODS: The automated system was trained to detect 15 classes of eyewear, masks, gloves, and gowns using an object detector and tracker. To assess how the system performs compared to human observers in detecting nonadherence, we designed a video surveillance experiment under 2 conditions: variations in video durations (20, 40, and 60 seconds) and the number of individuals in the videos (3 versus 6). Twelve nurses participated as human observers. Performance was assessed based on the number of detections of nonadherence. RESULTS: Human observers detected fewer instances of nonadherence than the system (parameter estimate -0.3, 95% CI -0.4 to -0.2, P < .001). Human observers detected more nonadherence during longer video durations (parameter estimate 0.7, 95% CI 0.4-1.0, P < .001). The system achieved a sensitivity of 0.86, specificity of 1, and Matthew's correlation coefficient of 0.82 for detecting PPE nonadherence. DISCUSSION: An automated system simultaneously tracks multiple objects and individuals. The system performance is also independent of observation duration, an improvement over human monitoring. CONCLUSION: The automated system presents a potential solution for scalable monitoring of hospital-wide infection control practices and improving PPE usage in healthcare settings.

High-order decomposition is a widely used model compression approach towards compact convolutional neural networks (CNNs). However, many of the existing solutions, though can efficiently reduce CNN model sizes, are very difficult to bring considerable saving for computational costs, especially when the compression ratio is not huge, thereby causing the severe computation inefficiency problem. To overcome this challenge, in this paper we propose efficient High-Order DEcomposed Convolution (HODEC). By performing systematic explorations on the underlying reason and mitigation strategy for the computation inefficiency, we develop a new decomposition and computation-efficient execution scheme, enabling simultaneous reductions in computational and storage costs. To demonstrate the effectiveness of HODEC, we perform empirical evaluations for various CNN models on different datasets. HODEC shows consistently outstanding compression and acceleration performance. For compressing ResNet-56 on CIFAR-10 dataset, HODEC brings 67% fewer parameters and 62% fewer FLOPs with 1.17% accuracy increase than the baseline model. For compressing ResNet-50 on ImageNet dataset, HODEC achieves 63% FLOPs reduction with 0.31% accuracy increase than the uncompressed model.