While improving hand hygiene (HH) could reduce infection rates, HH assessment is time consuming and not always objective. Electronic tools can now be used to generate comprehensive and objective data. Therefore, a recent study investigated the site-specific use of wall-mounted and point-ofcare dispensers using the electronic HH monitoring system NosoEx® on 17 wards in nine German hospitals [5]. Intensive care units lead in number of dispensers and disinfections The study anonymously recorded the rub volume of 931,446 hand disinfections and analysed the number and rub volume of wall-mounted and point-of-care dispensers by ward and room type. It was found that intensive care units (ICUs), intermediate care units (IMCs) and neurological wards had more dispensers than, for example, orthopaedic surgical wards, with wallmounted dispensers dominating overall (see figure). In addition, ICUs and IMCs were well ahead with more than three dispensers per bed and more than 20 disinfections per patient day. Hand rub dispenser use is location-dependent Interestingly, the study also showed that it is not just the number of dispensers that matters, but also where they are located and how they are used. For example, dispensers were more likely to be used in high-traffic areas such as hallways. It was also confirmed that hand Placement of disinfectant dispensers Practical experience: Observe workflows and locations! Recent data show that up to 6.5% of hospitalised patients in Europe and the USA are affected by healthcare-associated infections (HAIs) [1-3], which can lead to prolonged hospitalisation and increased consumption of antibiotics [4]. Figure 1: Mean number of hand rub dispensers (HRDs) per bed by ward type and comparison of POC and WMD numbers on individual wards. Bars show the averages of POCs and WMDs per ward type, while circles (WMD) and triangles (POC) show the individual numbers of HRDs per ward. Vertical lines indicate recommendations of German KRINKO (0.5 HRDs/bed on normal wards and one HRD/bed on ICU) and the number considered optimal (two HRDs/bed) [7]. ICU, intensive care unit; IMC, intermediate care; POC, point-of-care dispenser; WMD, wall-mounted dispenser. ward type orthopaedic/ surgical neurology other ICU IMC 0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 dispenser per bed wall-mounted dispenser (WMD) point-of-care dispenser (POC) KNOWLEDGE 18
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