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Efficacy of automated hand sanitiser dispensers in a teaching hospital

02 February 2022
10 mins read
Volume 13 · Issue 1
Figure 1. Collection of an aliquot of hand sanitiser onto a pre-weighed polyethylene grip seal bag.



Alcohol-based hand sanitisers are routinely used in healthcare establishments worldwide to reduce infection transmission. The volume of sanitiser dispensed has been shown to affect the efficacy of the hand hygiene event.


To assess whether the dispensed volume fulfils FDA requirements and if the implementation of a role in maintaining the sanitisers improved dispenser efficacy.


Samples were collected from 15 automated dispensers in a veterinary teaching hospital. Samples were collected daily on 6 consecutive days. This was repeated immediately following the assignment of a role to monitor and service the sanitisers, and again 8 months post implementation of the role.


Of the 270 aliquots collected, 54 (20%) and 216 (80%) were <1 ml and >1 ml, respectively. The mean volume dispensed in a single aliquot was significantly different from the target (1.2 ml). The volumes of sanitiser dispensed and the number of aliquots <1 ml did not change significantly between the three time points.


This study suggests that there is a high risk of inadequate hand sanitation when using automated dispensers, as a result of the inadequate volumes dispensed. Using dispensers automated to dispense larger volumes of sanitiser and encouraging self-reporting of perceived malfunctions may reduce these risks more than implementing a dispenser servicing role.

Ignaz Semmelweis is widely regarded as the father of hand hygiene. He observed in 1846 that the mortality rate as a result of puerperal sepsis significantly reduced if physicians cleaned their hands with a chlorine-based solution between each patient (Noakes et al, 2008). Since this discovery, hand hygiene has become widely accepted as one of the most effective interventions to reduce infection transmission and, more recently, to decrease antibiotic-resistant infection rates (Mitsuboshi and Tsugita, 2019).

Hand hygiene in healthcare settings is important both to reduce nosocomial infection rates and, in the case of veterinary medicine, the risk of zoonotic disease transfer to staff. A study looking at the infection control practices and zoonotic disease risks among veterinarians in the USA concluded that most USA-based veterinarians do not engage in practices that may help reduce zoonotic disease transmission (Wright et al, 2008). This study by Wright et al, found that only 55.2% (590/1069) of participants reported always washing their hands before eating, drinking, or smoking at work, and only 48.4% (516/1066) reported always washing their hands between patient contacts (Wright et al, 2008). A questionnaire-based study of private veterinary clinics in the USA also concluded that the hand hygiene practices among veterinary professionals was inadequate, with less than half of the respondents (76/182) reporting washing their hands regularly between patients (Nakamura et al, 2012). These studies, however, did not investigate the efficacy of a hand hygiene event when it was performed.

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