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Author: Chan B et al. (2013) Source: Infect Control Hosp Epidemiol 2013 Sep; 34 (9): 987-989


Chan B et al. (2013)

Effect of Varying the Number and Location of Alcohol-Based Hand Rub Dispensers on Usage in a General Inpatient Medical Unit

Background: Increasing the number of Alcohol-Based Hand Rub (ABHR) dispensers in healthcare facilities is considered to enhance the frequency of hand hygiene. So far mainly the impact of raising the number of dispensers has been studied. This study evaluates the effect of increasing the number and varying the location of ABHR dispensers on the frequency of hand hygiene events. At the same time it analyses which dispenser locations are preferred by health care workers.

Methods: Over a period of 6 months the number of dispensers in a unit with 10 single rooms was increased from 13 to 51 dispensers in 6 consecutive steps. Dispensers were mounted in the hallway, at the doorway of each room, by the end of beds and outside bathrooms. The number of patients was surveyed daily to calculate the number of hand hygiene events per patient per day. Dispensers were equipped with counters to measure the number of hand hygiene events.

Results: During the complete intervention period statistically significant increases and decreases of hand hygiene events could be found. In total mean hand hygiene events per patient per day increased from 31 to 38 events after the last intervention. The variation in the number of hand hygiene events was large, which had no identifiable cause. After the last intervention 51 dispensers were available in the unit. 63 % of the hand hygiene events involved dispensers in hallways. Inside the patient’s rooms 75 % of events were executed with the dispensers inside doorways. 19 % involved dispensers near the end of bed and only 6 % dispensers by bathrooms.

Conclusions: Adding ABHR dispensers beyond a certain point has a limited impact on hand hygiene events. The optimal number appeared to be 2 dispensers per bed for the evaluated unit. The location of ABHR dispensers is more important than the total number above a minimum threshold. Further study is needed to evaluate the effect of adding dispensers to the patient’s direct bedside. Hand hygiene during active patient care (not just before and after) has to be encouraged.

Download: Checklist for the right placement of hand disinfectant dispensers

Infect Control Hosp Epidemiol 2013  Sep; 34 (9): 987-989