Marsha Wallander, RN, is assistant director, accreditation services, for the Accreditation Association for Ambulatory Health Care.
Q: We are in the process of changing the type of hand sanitizers at our endoscopy locations. We are going to touchless dispensers. While implementing this, we decided to include the clinic exam rooms at the adjoining medical office as well. I need some advice about locating dispensers within the clinic rooms.
Within the endoscopy center, we are have always located sanitizer dispensers both in the hallway/common areas and inside the pre-op, sedation and PACU patient rooms since caregivers are to do hand hygiene each time they enter and exit a room.
Is there any organization that recommends or requires sanitizer be located within clinic exam rooms? We need to know if we should just put them in the hallway or also within the exam room. Part of this concern is because we have pediatric patients and are concerned about them playing with them and getting sprayed.
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Marsha Wallander: Common sense would seem to indicate that touchless dispensers of alcohol-based hand rubs (ABHRs) in the presence of pediatric patients would not be safe or practical. Installing ABHRs conveniently outside of clinic exam rooms would seem to be sufficient. If this clinic feels the need to have ABHRs inside of clinic exam space, consider supplying care providers with pocket-sized ABHR dispensers. There are many nationally-recognized guidelines defining safe placement of ABHR dispensers including CDC, NFPA, APIC and SHEA.
According to the CDC's "Guideline for Hand Hygiene in Health-Care Settings" (pdf) (2002): To improve hand-hygiene adherence among personnel who work in areas in which high workloads and high intensity of patient care are anticipated, make an alcohol-based hand rub available at the entrance to the patient's room or at the bedside, in other convenient locations, and in individual pocket-sized containers to be carried by HCWs (IA) (11,74,166,283,284,312,318,423).
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