Becker's Clinical Quality & Infection Control

16 INFECTION CONTROL What Happens When a Hospital NICU Goes Handshake-Free By Heather Punke I n an attempt to quell the spread of germs, two UCLA Medical Centers instituted so-called handshake-free zones in their neonatal intensive care units and published findings on the effects of the change in the American Journal of Infection Control. Prior research has shown handshakes are a major source of germ transfer — per one 2014 study in the American Journal of Infection Control, handshakes transfer nearly twice as much bacteria than a high-five, for instance. "We are trying to do everything except for the most obvious and easiest thing to do, in my opinion, which is to stop shaking hands," Mark Sklansky, MD, one of the authors of the most recent study, told NPR. Researchers from UCLA tested the feasibil- ity of establishing handshake-free zones by implementing them in the NICU at Ronald Reagan UCLA Medical Center and UCLA Santa Monica Hospital. ey hung signs around the unit explaining the new policy, printed educational materials for staff and patients and encouraged other forms of greetings, like nods, smiles or fist bumps. Additionally, they surveyed clini- cians and patients before and aer the zone was implemented to gauge reactions and if the number of handshakes actually dropped. e survey revealed patients' families preferred a greeting involving eye contact, a smile, being addressed by name and being asked about their well-being over a greeting involving a handshake. However, even aer the zones were im- plemented, about a third of clinicians on the units still did not support the hand- shake-free zones. One commented, "If I have done my job, the risk of spreading germs is minimal … hand-washing is key, not the handshake." Others believed not shaking hands wouldn't have an impact on infection rates, and failing to shake a parent's hand may come off as rude. Most of the clinicians who supported a no handshake policy were medical school stu- dents and nurses, while male physicians were more resistant to the change. Even though not all clinicians supported the handshake-free zone experiment, the number of handshakes in the two NICUs did decrease as a result of the experiment. While this study identified groups that may show resistance to going handshake-free and noted compliance with the handshake-free zone, it did not examine if infections went down as a result of the program. However, Dr. Sklansky "hopes to answer that question in a future study," according to NPR. n Hot or Cool: Water Temperature Does Not Impact Bacteria Removal During Hand-Washing, Study Shows By Anuja Vaidya C ool water is as effective as hot water for removing harmful bacteria, according to a study conducted by researchers at Rutgers University-New Brunswick (N.J.). For the study, researchers put high levels of harmful bacteria on the hands of 21 participants numerous times, over a six-month period. The participants then washed their hands in 60-de- gree, 79-degree or 100-degree water tempera- tures using 0.5 ml, 1 ml or 2 ml volumes of soap. Journal of Food Protection published the study. The study shows that water temperature as high as 100 degrees Fahrenheit and as low as 60 degrees Fahrenheit did not have a signifi- cant effect on bacteria reduction during hand washing. Additionally, researchers found no difference between the amount of soap used for reducing bacteria. However, further research is necessary to de- termine how much and what type of soap most impacts bacteria removal from hands. n To Up Patient Compliance With Hand Hygiene, Consider Ease of Use, Study Says By Heather Punke H and hygiene is an important aspect of infection prevention in any care setting, and patients are no exception. However, ease of use of and accessibility to some hand hygiene prod- ucts may preclude patients from properly cleaning their hands. In a study in the American Journal of Infection Control, researchers tested three hand sanitizer products — a pushdown pump bottle, a pocket-sized bottle with a reclosable lid and hand wipes — with 88 hospital patients and long-term care facility residents. Nearly all participants (86 of 88, or 97.7 percent) preferred the pump bottle, and the remaining two preferred the small bottle with the reclosable lid. Eight patients were unable to open the small bottle's lid, however. Additionally, none of the participants pre- ferred the wipes — comments revealed concerns about where to dispose of the used wipes and the lack of moister in the wipes. Researchers also compared the time it took patients to access each type of product. The pushdown pump bottles took the least amount of time to access (0.45 seconds) compared with the small- er bottle (3.86 seconds) or wipes (5.66 seconds). "Feasibility of product use could be a deciding factor in engaging patients in their personal hand hygiene practice," the study authors wrote. The study concludes, "In efforts to increase patient engagement and self-management of patient hand hygiene, infection pre- ventionists can use results of studies similar to this to implement products that are patient-centered." n

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