Assessing the optimal location for alcohol-based hand rub dispensers in a patient room in an intensive care unit.

Matthijs C Boog,Vicki Erasmus,Ed F Van Beeck,Elise A H E Van Beeck,Marijke Melles,Jitske M De Graaf

doi:10.1186/1471-2334-13-510

Matthijs C Boog, Vicki Erasmus + Show 4 more

Open Access

https://doi.org/10.1186/1471-2334-13-510

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Abstract

BackgroundThe introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene. However, establishing the best location for alcohol-based hand rub dispensers remains a problem, and no method is currently available to optimize the location of these devices. In this paper we describe a method to determine the optimal location for alcohol-based hand rub dispensers in patient rooms.MethodsWe composed a method that consists of a combination of qualitative and quantitative research methods. Firstly, different arrangements of dispensers were determined based on the results of two types of assessment: workflow observations and interviews with nurses and physicians. Each arrangement was then evaluated using two types of assessment: interviews with nurses and physicians and electronic measurements of the user frequency of the dispensers. This procedure was applied in a single-bed patient room on a thoracic surgery intensive care unit.ResultsThe workflow observations revealed that the activities of patient care were most often at the entrance and near the computer at the right side of the test room. Healthcare workers stated that the location of the dispenser should meet several requirements. Measurements of the frequency of use showed that the dispenser located near the computer, at the back of the room, was used less frequently than the dispenser located near the sink and the dispenser located at the entrance to the room.ConclusionThe applied method has potential for determining the optimal location for alcohol-based hand rub dispensers in a patient room. Workflow observations and the expressed preferences of healthcare workers guide the choice for the location of alcohol-based hand rub dispensers. These choices may be optimized based on measurement of the frequency of use of the dispensers.

Highlights

The introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene
Birnbach et al used a simulation in a real-size replica to evaluate the location of an alcoholbased hand rub (ABHR) dispenser; they found that when the dispenser was in clear view of the physicians this resulted in better compliance [8]
Site C and site B were the most frequently entered by healthcare workers (HCW)

Summary

Introduction

The introduction of alcohol-based hand rub dispensers has had a positive influence on compliance of healthcare workers with the recommended guidelines for hand hygiene. The ABHR dispensers were secured at the end of a trapeze-bar apparatus which was connected to the patient’s bed In this way the dispenser remains at eye level for attendants standing at bedside. This location resulted in a higher volume of use for ABHR compared to placing dispensers at the customary locations (e.g. on walls inside/outside the patient rooms, and adjacent to the lavatories) or placing the dispensers at customary locations in greater quantity. Nevo et al reported that compliance was improved when the front of the dispenser and an accompanying poster were in the line of sight on entering the room [9]

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