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Visitor characteristics and alcohol-based hand sanitizer dispenser locations at the hospital entrance: Effect on visitor use rates

      Highlights

      • We observed the visitor utilization of an alcohol-based hand sanitizers (AHS).
      • We examined if location of AHS and visitor characteristics influenced usage of AHS.
      • Location of AHS influences visitor's usage of the AHS.
      • Age and entering the hospital as a group influence the likelihood of visitors using AHS.

      Background

      Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital.

      Methods

      An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used.

      Results

      The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS.

      Discussion

      In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH.

      Conclusions

      The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH.

      Key Words

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      References

        • Hilburn J.
        • Hammond B.S.
        • Fendler E.J.
        • Groziak P.A.
        Use of alcohol hand sanitizer as an infection control strategy in an acute care facility.
        Am J Infect Control. 2003; 31: 109-116
        • Allegranzi B.
        • Pittet D.
        Role of hand hygiene in healthcare-associated infection prevention.
        J Hosp Infect. 2009; 73: 305-315
        • Garner J.S.
        • Simmons B.P.
        CDC guideline for isolation precautions in hospitals.
        Infect Control. 1983; 4: 247-325
        • Birnbach D.J.
        • Nevo I.
        • Barnes S.
        • Fitzpatrick M.
        • Rosen L.F.
        • Everett-Thomas R.
        • et al.
        Do hospital visitors wash their hands? Assessing the use of alcohol-based hand sanitizer in a hospital lobby.
        Am J Infect Control. 2012; 40: 340-343
        • Muder R.R.
        • Cunningham C.
        • McCray E.
        • Squier C.
        • Perreiah P.
        • Jain R.
        • et al.
        Implementation of an industrial systems-engineering approach to reduce the incidence of methicillin-resistant Staphylococcus aureus infection.
        Infect Control Hosp Epidemiol. 2008; 29: 702-708
        • Willison-Parry T.A.
        • Haidar E.A.
        • Martini L.G.
        • Coates A.R.
        Handwashing adherence by visitors is poor: is there a simple solution?.
        Am J Infect Control. 2013; 41: 928-929
        • Pittz E.P.
        Availability and use of hand hygiene products, by visitors, at the entry points of hospitals.
        Am J Infect Control. 2009; 37: E69-70
        • Wolfe R.
        • O'Neill E.
        Hand hygiene compliance by visitors to hospitals—can we do better?.
        Am J Infect Control. 2012; 40: 899-901
        • Henderson E.
        Hand hygiene and the transmission of bacilli in a neonatal intensive care unit.
        Clin Infect Dis. 2004; 38: 1688-1689
        • Lam B.
        • Lee J.
        • Lau Y.
        Hand hygiene practices in a neonatal intensive care unit: a multimodal intervention and impact on nosocomial infection.
        Pediatrics. 2004; 114: e565-71
        • Scheithauer S.
        • Oude-Aost J.
        • Heimann K.
        • Haefner H.
        • Schwanz T.
        • Waitschies B.
        • et al.
        Hand hygiene in pediatric and neonatal intensive care unit patients: daily opportunities and indication- and profession-specific analyses of compliance.
        Am J Infect Control. 2011; 39: 732-737
        • Afif W.
        • Huor P.
        • Brassard P.
        • Loo V.G.
        Compliance with methicillin-resistant Staphylococcus aureus precautions in a teaching hospital.
        Am J Infect Control. 2002; 30: 430-433
        • Chagpar A.
        • Banez C.
        • Lopez R.
        • Cafazzo J.A.
        Challenges of hand hygiene in healthcare: the development of a tool kit to create supportive processes and environments.
        Healthcare Q. 2010; 13: 59-66
        • Cochrane J.
        Infection control audit of hand hygiene facilities.
        Nurs Stand. 2003; 17: 33-38
        • Kesavan S.
        • Barodawala S.
        • Mulley G.P.
        Now wash your hands? A survey of hospital handwashing facilities.
        J Hosp Infect. 1998; 40: 291-293
        • Pittet D.
        The Lowbury lecture: behaviour in infection control.
        J Hosp Infect. 2004; 58: 1-13
        • Whitby M.
        • Pessoa-Silva C.L.
        • McLaws M.L.
        • Allegranzi B.
        • Sax H.
        • Larson E.
        • et al.
        Behavioural considerations for hand hygiene practices: the basic building blocks.
        J Hosp Infect. 2007; 65: 1-8
        • Sandora T.J.
        • Taveras E.M.
        • Shih M.C.
        • Resnick E.A.
        • Lee G.M.
        • Ross-Degnan D.
        • et al.
        A randomized, controlled trial of a multifaceted intervention including alcohol-based hand sanitizer and hand-hygiene education to reduce illness transmission in the home.
        Pediatrics. 2005; 116: 587-594
        • Rosenthal V.D.
        • Guzman S.
        • Safdar N.
        Reduction in nosocomial infection with improved hand hygiene in intensive care units of a tertiary care hospital in Argentina.
        Am J Infect Control. 2005; 33: 392-397
        • Pittet D.
        • Mourouga P.
        • Perneger T.V.
        Compliance with handwashing in a teaching hospital.
        Ann Intern Med. 1999; 130: 126-130
        • O'Sullivan I.
        • Orbell S.
        • Rakow T.
        • Parker R.
        Prospective research in health service settings: health psychology, science and the ‘Hawthorne‘ effect.
        J Health Psychol. 2004; 9: 355-359
        • Pittet D.
        • Simon A.
        • Hugonnet S.
        • Pessoa-Silva C.L.
        • Sauvan V.
        • Perneger T.V.
        Hand hygiene among physicians: performance, beliefs, and perceptions.
        Ann Intern Med. 2004; 141: 1-8