Investigation of the influence of bacterial contamination in hand-operated refillable soap dispenser on the outcome of hand washing

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Investigation of the influence of bacterial contamination in hand-operated refillable soap dispenser on the outcome of hand washing


Author: Tam, Lai Ching Jacqueline
Title: Investigation of the influence of bacterial contamination in hand-operated refillable soap dispenser on the outcome of hand washing
Degree: M.Sc.
Year: 2013
Subject: Hand washing.
Microbial contamination -- Prevention.
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: 60 leaves : illustraions ; 30 cm
Language: English
InnoPac Record:
Abstract: BACKGROUND: Antiseptic agents can remove and kill transient flora on the hands of healthcare workers (HCWs), and their use is indicated in surgical, invasive and device insertion procedures and in isolation, high-risk and critical care units. The aim of using antiseptic agents is to achieve better hand hygiene and prevent health care-associated infections (HAIs). Refillable dispensers can act as an extrinsic source of HAIs. Bacteria survive in the refillable dispensers and are transferred to the hands of HCWs. Thus, the efficacy of hand hygiene is decreased by the use of contaminated refilled dispensers. AIMS: This study aimed to investigate (i) the extent of bacterial contamination in hand-operated refillable soap dispensers containing chlorhexidine, and (ii) evaluate the difference in reduction of bacterial load on the hands of healthcare workers after hand washing using contaminated and non-contaminated refillable soap dispensers containing chlorhexidine in hand-operated pumps.
METHODS: Fifty-four hand-operated refillable soap dispensers containing chlorhexidine gluconate from three parts of the dispenser: the piston, the nozzle and the pump tube. Dey-Engly neutralizer was used to inhibit the bactericidal activity of CHG. Swab mixed with 1ml neutralizer for 30 seconds. Then 0.1ml of mixed content was aspirated and spread on the agar plate. After incubation of the agar plate, the bacterial colonies were counted to identify the degree of contamination of the dispensers. Twenty HCWs washed their hands with the contents of one contaminated dispenser and one non-contaminated dispenser. Three consecutive hand washings were conducted at 30 minutes intervals to evaluate the immediate effect of CHG after hand washing. Glove fluid samples were collected before and immediately after each hand washing, and bacterial colonies were counted after the incubation of the fluids. RESULTS: Overall, 24% (13/54) dispensers were contaminated, the percentage of contamination varied among the various hospital areas: 88% (7/8) dispensers from isolation wards,50% (5/10) from the laboratories, 10% (1/10) from ICU, and 0% (0/26) from general wards. No statistically significant difference was observed in the percentage of reduction in bacterial counts when using contaminated rather than non-contaminated dispensers for hand washing. The results thus provided no evidence that the use of contaminated hand-operated refillable soap dispensers influenced the outcome of hand washing. However, they did show that the CHG in these refillable soap dispensers contained bacteria and that contaminated dispensers were most frequently located in the isolation wards. CONCLUSION: The results of this study suggested that hand-operated refillable soap dispensers could be contaminated with bacteria and this potential risk cannot be neglected. However,these results showed no statistically significant difference in the extent of bacterial reduction after hand washing with either contaminated or non-contaminated dispensers. The risk of HAI transmission could be reduced by replacing the refillable type of soap dispenser with disposable type.

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