Decontaminating gel dispensers can reduce bacteria, study finds

Simple remedies, such as keeping antibacterial gel dispensers clean and giving healthcare workers their own hand sanitiser, can help keep patients safe by decreasing contamination in operating and recovery rooms, suggest two studies presented at the Anesthesiology 2013 annual meeting.

Keeping hand sanitisers clean decreases their bacterial contamination by 75%, while healthcare workers with personal gel bottles attached to their belts were nearly 30% more likely to use the hand sanitiser, the studies found.

The studies investigated operating room contamination, resulting in common sense remedies to increase sanitisation. The first looked at bacterial counts on such high-touch surfaces as the hand sanitiser dispenser and the electronic medical record keyboard. The second followed the compliance of a hand hygiene policy before and after personal sanitation gel devices were worn on the belts of medical staff.

'Perioperative infection and contamination is a serious threat to patient safety,' said Devon Cole, from the Department of Anesthesiology, University of Florida, Gainesville.

'The hand sanitiser is touched to sanitise a presumably unsanitary hand and is therefore uniquely vulnerable to contamination. It just made sense to measure the bacteria on the dispenser handles of these containers.'

Sanitiser dispensers were sampled at four-hourly intervals at two hospitals during the working day and also at 5am and 8 pm. At the first hospital, all dispensers were cleaned with a germicidal disposable wipe after each patient was discharged. At the second hospital, there was no disinfection of the dispensers.

Routine cleansing of the dispensers will reduce this reservoir of bacteria

The dispensers accumulated a rising number of bacteria throughout the day at both hospitals. However, the number of bacterial colony-forming units at the second hospital was significantly higher. At 5am and 8pm, there was an average of one bacterial unit. At the end of the day, an average of 93 bacterial units had accumulated on the dispensers. At the first hospital, the number of bacterial units rose from one at 5am to 23 at 6pm, significantly less than the second hospital.

'Often the last object touched by the anesthesia provider before the patient's IV is the hand sanitiser dispenser,' said Cole. 'Too small a volume of sanitising gel, inadequate coverage of fingertips and a short drying time will all enable bacteria to persist on the providers' hands. Routine cleansing of the dispensers will reduce this reservoir of bacteria.'

In the second study, healthcare workers were observed for compliance with the hand hygiene policy before and after they were given a personal sanitation gel dispensing device to be worn on their belts. Next, compliance rates with and without the personal sanitation gel dispenser were compared.

'Despite the availability of wall-mounted hand sanitation dispensers, compliance was less than ideal,' said Colby Parks, from the Department of Anesthesia at the University of Wisconsin, Madison. 'This study shows that a simple intervention in which a personal antibacterial hand gel dispenser is readily available, works better for a busy healthcare provider's workflow pattern, presumably leading to decreased patient and surrounding-care-area contamination.'

The study found that the overall compliance with the hand hygiene protocol after the implementation of personal gel dispensers increased 29%. More than 307 encounters were observed.

In the 146 encounters prior to the implementation of the personal gel dispensers, compliance for pre- and post-patient contact hand hygiene was 23% and 43%, respectively. For the 161 encounters after the individual gel dispensers were provided, the compliance for pre- and post-patient contact was 53% and 72%, respectively.