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Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?

OBJECTIVE: To determine whether microbial contamination of door handles in two busy intensive care units and one high dependency unit was related to their design, location, and usage. DESIGN: Observational study of the number of viable bacteria on existing door handles of different design at defined...

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Autores principales: Wojgani, Hedieh, Kehsa, Catherine, Cloutman-Green, Elaine, Gray, Colin, Gant, Vanya, Klein, Nigel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471909/
https://www.ncbi.nlm.nih.gov/pubmed/23077475
http://dx.doi.org/10.1371/journal.pone.0040171
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author Wojgani, Hedieh
Kehsa, Catherine
Cloutman-Green, Elaine
Gray, Colin
Gant, Vanya
Klein, Nigel
author_facet Wojgani, Hedieh
Kehsa, Catherine
Cloutman-Green, Elaine
Gray, Colin
Gant, Vanya
Klein, Nigel
author_sort Wojgani, Hedieh
collection PubMed
description OBJECTIVE: To determine whether microbial contamination of door handles in two busy intensive care units and one high dependency unit was related to their design, location, and usage. DESIGN: Observational study of the number of viable bacteria on existing door handles of different design at defined entry/exit points with simultaneous data collection of who used these doors and how often. SETTING: Two busy specialised intensive care units and one high dependency unit in a tertiary referral NHS neurological hospital. MAIN OUTCOME MEASURES: Surface bacterial density on door handles with reference to design, location, and intensity of use. RESULTS: We found a significant correlation between the frequency of movements through a door and the degree to which it was contaminated (p = <0.01). We further found that the door's location, design and mode of use all influenced contamination. When compared to push plate designs, pull handles revealed on average a five fold higher level of contamination; lever handles, however, displayed the highest levels of bacterial contamination when adjusted for frequency of use. We also observed differences in contamination levels at doors between clinical areas, particularly between the operating theatres and one of the ICUs. CONCLUSIONS: Door handles in busy, “real life” high acuity clinical environments were variably contaminated with bacteria, and the number of bacteria found related to design, location, mode and frequency of operation. Largely ignored issues of handle and environmental design can support or undermine strategies designed to limit avoidable pathogen transmission, especially in locations designed to define “thresholds” and impose physical barriers to pathogen transmission between clinical areas. Developing a multidisciplinary approach beyond traditional boundaries for purposes of infection control may release hitherto unappreciated options and beneficial outcomes for the control of at least some hospital acquired infections.
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spelling pubmed-34719092012-10-17 Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors? Wojgani, Hedieh Kehsa, Catherine Cloutman-Green, Elaine Gray, Colin Gant, Vanya Klein, Nigel PLoS One Research Article OBJECTIVE: To determine whether microbial contamination of door handles in two busy intensive care units and one high dependency unit was related to their design, location, and usage. DESIGN: Observational study of the number of viable bacteria on existing door handles of different design at defined entry/exit points with simultaneous data collection of who used these doors and how often. SETTING: Two busy specialised intensive care units and one high dependency unit in a tertiary referral NHS neurological hospital. MAIN OUTCOME MEASURES: Surface bacterial density on door handles with reference to design, location, and intensity of use. RESULTS: We found a significant correlation between the frequency of movements through a door and the degree to which it was contaminated (p = <0.01). We further found that the door's location, design and mode of use all influenced contamination. When compared to push plate designs, pull handles revealed on average a five fold higher level of contamination; lever handles, however, displayed the highest levels of bacterial contamination when adjusted for frequency of use. We also observed differences in contamination levels at doors between clinical areas, particularly between the operating theatres and one of the ICUs. CONCLUSIONS: Door handles in busy, “real life” high acuity clinical environments were variably contaminated with bacteria, and the number of bacteria found related to design, location, mode and frequency of operation. Largely ignored issues of handle and environmental design can support or undermine strategies designed to limit avoidable pathogen transmission, especially in locations designed to define “thresholds” and impose physical barriers to pathogen transmission between clinical areas. Developing a multidisciplinary approach beyond traditional boundaries for purposes of infection control may release hitherto unappreciated options and beneficial outcomes for the control of at least some hospital acquired infections. Public Library of Science 2012-10-15 /pmc/articles/PMC3471909/ /pubmed/23077475 http://dx.doi.org/10.1371/journal.pone.0040171 Text en © 2012 Wojgani et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Wojgani, Hedieh
Kehsa, Catherine
Cloutman-Green, Elaine
Gray, Colin
Gant, Vanya
Klein, Nigel
Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title_full Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title_fullStr Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title_full_unstemmed Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title_short Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
title_sort hospital door handle design and their contamination with bacteria: a real life observational study. are we pulling against closed doors?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3471909/
https://www.ncbi.nlm.nih.gov/pubmed/23077475
http://dx.doi.org/10.1371/journal.pone.0040171
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