The importance of evaluating product dispensers when selecting alcohol-based handrubs.
BACKGROUND
To promote improved hand hygiene among personnel, a hospital installed dispensers for an alcohol-based hand rinse throughout the facility. Soon after installation, dispensers began to malfunction and continued to do so despite efforts to rectify the problem.


METHODS
Sixteen months after installation, dispensers in all patient rooms were examined, and surveyors recorded the condition of dispensers, the number of times the dispenser lever was pressed to obtain product, how the product was delivered onto the hand, and a qualitative estimate of the volume delivered.


RESULTS
Of 166 dispensers, 2% were broken, 7% had no product container, 5% had an empty product container, 9% contained product but were totally obstructed, and 77% were functional. Of the 128 functional dispensers, 65% delivered product after a single stroke of the lever, 13% after 2 strokes, 9% after 3 strokes, and 13% after 4 or more strokes. Seventeen percent delivered a small volume onto the hand, and 16% squirted the product onto the wall or floor.


CONCLUSIONS
Evaluation of alcohol-based handrubs should consider not only product characteristics, user acceptability, skin tolerance, and cost but also the design and function of the dispensers that will ultimately be installed.
D000438:Alcohols; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003625:Data Collection; D004356:Drug Storage / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D006235:Hand Disinfection / Q000379:methods; D006801:Humans; D019064:Product Packaging / Q000592:standards* / Q000706:statistics & numerical data*
D000438:Alcohols; D000891:Anti-Infective Agents, Local