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Author: Cure L. / Van Enk R. (2015) Source: Cure, L., Van Enk, R.: Effect of hand sanitizer location on hand hygiene compliance. American Journal of Infection Control, 2015, Vol. 43: 917-921

STUDY

Cure L. / Van Enk R. (2015)

Effect of hand sanitiser location on hand hygiene compliance

Background: Hand hygiene is a generally accepted method to prevent nosocomial infection. Compliance-promoting interventions usually take aim at differing hand hygiene factors. One central factor of success for compliance is the infrastructure of hand disinfectant dispensers. In their study, Cure and Van Enk hence investigated to what extent hand hygiene compliance is linked to a user-friendly and standardised installation of hand disinfectant dispensers.


Method:
In an American 404-bed hospital, between 2010 and 2012 Cure and Van Enk systematically evaluated the hand disinfectant dispenser locations’ influence on the compliance in 12 wards. For this, they first assessed the locations according to usability and standardisation. Then, hidden observers recorded the compliance rates of the employees.

The usability of dispensers was assessed using the following criteria:

  • good visibility when entering the room
  • easy and unhindered access
  • within reach or less than one step away from the patient room entrance
  • visible from the point of care
  • readily accessible during a working procedure
  • within reach or less than one step away from the point of care
  • installed at optimal height (85 to 100 cm above the ground).

The hand disinfectant dispensers were retrofitted in the wards only after the construction of the hospital – hence, the locations of the dispensers differed in rooms and wards. To determine whether a standardised installation influences the compliance, the researchers used a standardisation score in every ward that assessed how much the dispenser locations differed from room to room in one ward. A score of 1 meant that the locations of dispensers were the same in all of the ward’s rooms. If the dispenser location was only the same in 60 % of the rooms the score was 0.6.


Results: Between 2010 and 2012, the observers recorded a total of 20 707 hand disinfection procedures. The overall compliance rate was around 82 %. The standardisation score was between 0.2 and 1. Statistical evaluation showed: easily accessible hand disinfectant dispensers had a significant positive effect on hand hygiene compliance. The following two factors were particularly influential: installation near the door and good visibility of the hand disinfectant dispenser. The standardisation of the location also correlated with the compliance, but was not significant.


Conclusions: Hand hygiene compliance can be influenced by installing hand disinfectant dispensers in a location that is well visible and easily accessible. With their study, Cure and Van Enk demonstrated a positive correlation between dispenser usability and compliance. Factors such as good visibility and installation near doors proved to be particularly influential.

The authors sum up that it is therefore important to integrate the location and usability of hand disinfectant dispensers into multimodal intervention programmes to sustainably improve hand hygiene.


Source:
Cure, L., Van Enk, R.: Effect of hand sanitizer location on hand hygiene compliance. American Journal of Infection Control, 2015, Vol. 43: 917-921


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