A novel ergonomic wheelchair reduces bacterial hand contamination

Abstract

Objective To determine whether bacterial contamination of rider’s hands is less with a novel ergonomic wheelchair (EW) than a standard wheelchair (SW). Experimental design After wheelchair hand rims were disinfected, volunteers wearing nitrile gloves propelled each wheelchair through a standardised “run” in hospital. Post-run cultures were obtained from riders' gloved hands. Bacterial hand counts were compared between runs matched by rider (same rider, different chairs) or time (different riders in each chair, running concurrently), and overall. Setting Minneapolis Veterans Affairs Health Care System (MVAHCS), a large tertiary care facility. Participants Eleven employee volunteers. Intervention EW, as compared with SW. With SW, co-location of hand rims and tyres potentially exposes the user’s hands to tyres, which risks contaminating the user’s hands with ground-source bacteria. Our novel ergonomic wheelchair (EW) separates drive wheel and hand rims, potentially reducing hand contamination. Main outcome measure Bacterial hand counts. Results Post-run bacterial hand counts were over 10-fold lower with the EW than the SW. This was true (i) when the same rider tested both chairs sequentially (n = 8 pairs) (median counts, 40 vs. 1030; p = 0.008), (ii) when different riders tested the two chairs concurrently (n = 9 pairs) (median counts, 40 vs. 660; p = 0.004), and (iii) overall (median counts, 40 [n = 9 runs] vs. 550 [n = 10 runs]; p < 0.001). Conclusion Separation of wheelchair hand rims from tyres significantly reduces bacterial hand contamination. Reduced hand contamination could decrease bacterial infections and dissemination of resistant bacteria, warranting further study. Implications for rehabilitation The novel design of the ergonomic wheelchair, removing the push rim from proximity to the wheelchair tyre, keeps the hands of wheelchair users cleaner. The re-design of the standard manual wheelchair was implemented initially to improve shoulder ergonomics during manual wheelchair propulsion and has the added benefit of reduction in the transfer of bacteria from floors to hands for manual wheelchair users. Since the ergonomic wheelchair has the potential to decrease rates of bacterial infection in manual wheelchair users, further testing is warranted.