Becker's Clinical Quality & Infection Control

25 INFECTION CONTROL & PATIENT SAFETY How Much Hand Sanitizer is Enough? By Heather Punke M ost international standards for hand sanitizer used in healthcare settings do not take hand size into account when recommending how much hand sanitizer to use, but a study in the American Journal of Infection Control says that shouldn't be the case. Researchers invited 67 visitors at an infection prevention and control confer- ence in Switzerland to perform hand hygiene using ultraviolet light-traced hand sanitizer and check how well the sanitizer covered their hands. Three volumes of hand sanitizer were used: 1 mL, 2 mL and 3 mL. The researchers examined the coverage on palms and back of hands of 134 hands. They found that 1 mL was "never sufficient for effective hand hygiene," even if the person had small hands. Findings also suggested 3 mL would be sufficient for people with small or medium hands, but it was not sufficient to cover palms and backs of hands for people with large hands. "The volume of applied [hand sanitizer] needs to be adapted to hand size if both palm and dorsum are to be covered," the study concluded. n Ambulances Could Be Bacterial Infection Source By Brian Zimmerman E mergency medical service vehicles may harbor micro- organisms that can cause infections, according to a study published in the American Journal of Infection Control. For the study, researchers ex- amined samples extracted from 10 ambulances serving Bilbao, Spain. Samples were taken from six areas on the ambulance: two in the driver's cab and four in the patient area. The highest levels of infectious microbes were collect- ed from the steering wheel, the inside handle of the passenger door and the stretcher handles. Among the microbes detected were three cultures of Staphylo- coccus aureus, which were found in two of the ambulances. These findings suggest cross-con- tamination occurs between the patient area and the driver's cab due to non-preventative practices like driving with gloved hands after assisting a patient and poor hand-washing practices. Guillermo Quindós, professor of microbiology at the University of the Basque Country in Leioa, Spain, and the study's coordina- tor, said the findings highlight the importance of good hand hygiene and infection prevention protocols. "The existence of a protocol is desirable because it facilitates the carrying out of proper disinfection by stipulating in detail the steps to be taken," said Dr. Quindós. "Among the people working in healthcare the hand washing habit is poor and it would be nec- essary to build awareness about the importance of this hygiene measure to prevent microbial contamination." n Nurses' Scrubs Likely Aid Spread of Germs to Patients, Study Finds By Heather Punke N urses' clothing — especially sleeves and pockets — can play a role in the transmission of bacteria in hospitals, according to research presented at IDWeek 2016. e study involved 167 patients who received care from 40 nurses during three separate, 12-hour shis in the intensive care unit, for a total of 120 individual shis. All nurses cared for two or more patients per shi and changed scrubs for each shi. Researchers took cultures twice a day from nurses' scrubs, the patients and the patients' rooms. ey cultured sleeves, pockets and midriffs of the scrubs as well as the supply cart, bed and bed rails. ey found 22 transmissions of the same strain of bacteria. Of those, six were from patient to nurse, six were from room to nurse and 10 were from patient to room. Transmitted bacteria included methicil- lin-resistant Staphylococcus aureus, Klebsiel- la pneumoniae and Pseudomonas aerugino- sa, among others. e spots most likely to be contaminated were the sleeves and pockets of the scrubs and the bed rails. "We think it's more common than not that these bugs spread to patients in hospitals because of temporary contamination of healthcare workers," said Deverick An- derson, MD, lead author of the study and associate professor of medicine at Duke University Medical Center in Durham, N.C. He noted three actions that play a major role in stopping the spread of bacteria: • Hand-washing aer every patient encounter • Using disposable gloves and gowns when treating patients with specific infections • Regular cleaning of patients' rooms n

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