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How do you keep ORs clean? Give doctors personal hand sanitizers

Smart tactics: Clean hand sanitizer dispensers, personal gel bottles

Topics: Performance Improvement, Quality, Infection Control, Infectious Diseases

October 15, 2013

Simple remedies—including keeping anti-bacterial gel dispensers clean and giving medical personnel their own hand sanitizers—would reduce infections in the OR, according to a pair of studies presented last week at the American Society of Anesthesiologists' (ASA) 2013 annual meeting.

Study one: Keep anti-bacterial gel dispensers clean

For the first study, researchers examined bacterial counts on high-touch surfaces, such as the hand sanitizer dispenser and the electronic medical record keyboard, at two separate hospitals. At the first hospital, hand sanitizer dispensers were cleaned with a germicidal wipe after each patient was discharged. At the second hospital, no disinfection steps were taken between patients. Dispensers were sampled at four-hour intervals throughout the work day and also at 5 a.m. and 8 p.m.

Hospitals aim to boost hygiene
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Gold stars and 'red cards'
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Pop quizzes and white boards
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Monitoring technology
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Pushing patients to ask

Although hand sanitizer dispensers at both hospitals accrued bacteria throughout the day, disinfecting the hand sanitizers at the first hospital helped reduce contamination by 75%.

The University of Florida's Devon Cole says that "often the last object touched by the anesthesia provider before the patient's IV is the hand sanitizer dispenser." However, he adds, "Too small a volume of sanitizer, inadequate coverage of finger tips, and a short drying time will all enable bacteria to persist on the providers' hands."

Second study: Give doctors their own sanitizers

In the second study, attending physicians, fellows, residents, and nurses were observed for compliance with hand hygiene policies before and after they were given individual gel dispensing devices to wear on their belts. Overall, the researchers observed 307 patient encounters.

The study found that overall compliance with hand hygiene protocol rose by 29% after staffers were given personal gel dispensers. Specifically:

  • In 146 encounters observed before the personal sanitizers were distributed, compliance for pre- and post-patient contact hand hygiene protocols was 23% and 43%, respectively.
  • In the 161 encounters observed after the personal sanitizers were distributed, compliance for pre- and post-patient contact was 53% and 72%, respectively.

"Despite the availability of wall-mounted hand sanitation dispensers, compliance was less than ideal" prior to the new hand hygiene protocol, says Colby Parks of the University of Wisconsin-Madison, adding, "This study shows that a simple intervention in which a personal antibacterial hand gel dispenser is readily available, works better for a busy health care provider's workflow pattern, presumably leading to decreased patient and surrounding-care-area contamination" (ASA release, 10/13; UPI, 10/14).

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