Hands-On Technology

This package enables discreet monitoring of hand-hygiene practices.

IF you happen to be eating--especially at your desk--you might want to set the sandwich down. Research has been done, and the results are not appetizing.

In a University of Arizona study of business offices in several U.S. cities, microbiologists found bacteria levels on desktops to be 400 times greater than on the toilet seats in the same offices. (On second thought, you might want to hold on to that sandwich.) A typical keyboard, they found, plays host to 3,295 germs per square inch, which sounds bad until you compare it to the average office phone, which harbors up to 25,127 germs per square inch. And that's just the start of it.

Why the infestation? Essentially, because we touch these objects and thereby transfer the germs that have adhered to our hands after grasping doorknobs, books, money, you name it--every surface we touch is teeming with the stuff. Our hands can hold anywhere from a million to a billion invisible bacteria and viruses, some of which are known to live two hours or longer when given a dry, warm setting. As myriad as they are, these transient microorganisms would often not faze us if we were regular and thorough about washing up. But as a rule, most of us aren't.

On the Average
The Soap and Detergent Association's 2004 Clean Hands Report Card gave Americans a "C" for hand hygiene based on survey results finding 43 percent of us seldom or never wash our hands after coughing or sneezing, 32 percent don't always wash before eating lunch, and 54 percent don't wash long enough to make an effective difference. Based on entirely unofficial observations, I'd say these percentages are conservative and the SDA's grading system is generous.

The consensus among health and hygiene agencies and associations is that the lathering part of a routine handwash should be vigorous and last for a minimum of 15 seconds, 20 seconds being optimal--about the length of time it takes you to hum all of "Yankee Doodle."

This is nothing we haven't heard from parents, teachers, school nurses, and hopefully others since we were old enough to almost reach the faucet, I realize, but when the American Society for Microbiology can release a study, as it recently did, saying 30 percent of us don't wash our hands after using a public restroom, clearly not all of us got the message.

No one would dispute the CDC's assertion that hand hygiene is the single most important way to prevent the spread of germs that may cause illness. According to the CDC Web site, the causal link between contaminated hands and infectious disease transmission is one of the best-documented phenomena in clinical science. But when even professionals who wear "scrubs" for a living are falling short (fewer than half of health care workers wash their hands properly in between patients, experts estimate), we have a problem of near-epidemic proportions. To help clean up the problem, high-tech solutions increasingly are being applied to what is otherwise a low-tech practice.

Lather, Rinse, Compute
A number of electronic hand hygiene systems have surfaced in recent years. You've probably noticed them unless you're among the 30 percent who don't bother stopping at the sink. Some of the systems have voices directing you through the "hand hygiene event" or "episode." The more sophisticated systems even detect when you "forget" and then call you back to do your duty.

The SIGNOLTM Hand Hygiene Event Monitor, a hardware and software package from Akron, Ohio-based GOJO® Industries Inc., takes a less intrusive approach. It uses a hidden device about the size of a business card that's easy to install and relocate in any of GOJO's nine models of 800 ml dispensers. The device sounds an audible tone when the optimal 20-second lather time is up.

The modular device has an LCD screen showing the recorded number of hand hygiene events that have taken place at a particular station, 24 hours a day, seven days a week. In facilities where tracking and recording such numbers are required, an infection control practitioner or risk manager can quickly access the numbers and enter them in the SIGNOL system's spreadsheet-based software, which extrapolates the data into user-defined categories based on specific settings, providing easy and accurate documentation.

According to Bruce Van Deman, GOJO Healthcare director of marketing, the food service and health care industries are the system's primary users. Periodic monitoring and recording of hand hygiene episodes by health care workers is a Category 1 Recommendation of the CDC, and the FDA's Food Code for retail outlets and institutions has provisions regarding how long and when employees must wash their hands. But even in industries that don't require hand hygiene for compliance, SIGNOL offers an effective solution for reaching performance goals and following a program based on best practices.

"We're not trying to change behaviors with this device," Van Deman said. "Whether it's in the food service, food processing, hospital, or some other setting, people don't want to know that they're being monitored, and this system offers a really convenient and discreet technology managers can use to get the information they need. And there's no negative influence."

SIGNOL's pricing starts at around $30, Van Deman said, with the variety of dispensers sold separately. The dispensers themselves can use any lotion soap or sanitizer, though GOJO recommends its own brands for best results. On the whole, industries remain divided pretty evenly between which types of soap are most effective. "Whatever camp you're in--the bland soap camp or the antibacterial camp--we've got you covered," Van Deman said. "We just want you to wash your hands."

For more information on SIGNOL, visit www.healthcare.gojo.com. For more information from the CDC on hand hygiene, visit www.cdc.gov/cleanhands.

This column appears in the February 2005 issue of Occupational Health & Safe

This article originally appeared in the February 2005 issue of Occupational Health & Safety.

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