Increasing Patient Accessibility and Use of Hand Sanitizer Through Introduction of a Single-Dose Packet

Abstract

BACKGROUND Preventing pathogen transmission via healthcare worker (HCW) hand hygiene (HH) is well-established. Emerging evidence suggests patients contaminate their environment with their flora and acquire pathogens on their hands through HCW and environment contact; therefore, there has been increasing interest in patient HH despite lack of guidance. Single-dose hand sanitizer packets (SDP) were evaluated as a solution for accessible patient HH. METHODS In a 270-bed hospital, Infection Preventionist randomly solicited patient participation in a study during daily rounds. Patients between September 4–17, 2018 were assigned to the control group (n=32), patients between September 18–November 28, 2018 were assigned to the intervention (n=35). A 7-question baseline survey assessing sanitizer accessibility and HH practices was distributed to the control group. The intervention group received a 24-count SDP via admission kit. Participants were not instructed how/when to use the SDP. A 9-question survey was distributed to the intervention group, including questions on hand cleaning practices, sanitizer accessibility, and evaluation of SDP. Results were analyzed with an independent samples t-test (α=0.05). RESULTS The intervention group reported higher access to hand sanitizer than the control (mean of 5-point scale, 4.8 and 3.5, respectively; p˂0.001). Patients in the intervention group had higher sanitizer usage (mean of 4-point scale, 3.8 and 2.7, respectively; p˂0.001) and rated higher that they were able to keep their hands germ-free (mean of 5-point scale, intervention 4.7 and control 3.7; p˂0.001). Soap and water usage was higher in the control group (mean of 4-point scale, control 3.2 and intervention 2.4; p=0.003). CONCLUSIONS Patients reported that SDP increased sanitizer accessibility, helped keep their hands germ-free, and increased their hand sanitizer usage. Considering limitations around sink and wall dispenser accessibility and cost constraints with providing patients individual sanitizer bottles, SDP could be a promising solution for admission kits.