Effect of an automated sink on handwashing practices and attitudes in high-risk units.
OBJECTIVE
To assess the effects of an automated sink on handwashing practices and attitudes of staff.


METHODS
Quasi-experimental crossover design.


METHODS
Two high-risk patient care areas, one postanesthesia recovery room (Site 1), and one neonatal intensive care unit (Site 2) in two tertiary care hospitals.


METHODS
All patient care staff on study units; approximately 55 individuals.


METHODS
An automated sink was installed to replace one handwashing sink for about five weeks; the sink was then crossed-over for an equivalent time period to the other location. Handwashing practices of all unit staff were observed in three two-hour observation periods/week. Questionnaires were distributed to staff two weeks after sink installation and at the study's end.


RESULTS
One thousand, six hundred ten handwashes were observed. Handwashing practices differed significantly by site. For both sites, hands were washed significantly better but significantly less often with the automated sink (all p less than .001). Staff expressed negative attitudes, however, about certain features of the sink, and these negative attitudes increased over the study period.


CONCLUSIONS
Automated devices must be flexible enough to allow adjustments based on staff acceptance. Application of new technology to improve hand hygiene requires a multifaceted approach to behavior change.
Johns Hopkins University and Hospital, Baltimore, Maryland 21205.
E
E
Larson
A
A
McGeer
Z A
ZA
Quraishi
D
D
Krenzischek
B J
BJ
Parsons
J
J
Holdford
W J
WJ
Hierholzer
D000762:Anesthesia Recovery Period; D001291:Attitude of Health Personnel; D001331:Automation; D006235:Hand Disinfection; D006801:Humans; D007363:Intensive Care Units, Neonatal; D010564:Personnel, Hospital; D011997:Recovery Room; D011795:Surveys and Questionnaires