title: Visitor characteristics and alcohol-based hand sanitizer dispenser locations at the hospital entrance: Effect on visitor use rates.
abstract: BACKGROUND
  Hospital visitors' hand hygiene (HH) is an important aspect of preventing health care-associated infections, but little is known about visitors' use of alcohol-based hand sanitizers (AHS). The study aim was to examine if use of AHS is influenced by visitor characteristics and the location of AHS within the lobby of a large hospital.
  
  
  METHODS
  An observational study was conducted with AHS placed in 3 different locations. The data included visitor characteristics and if AHS were used.
  
  
  RESULTS
  The results suggest that visitors are 5.28 times (95% confidence interval [CI], 3.68-7.82) more likely to use AHS when dispensers are located in the middle of the lobby with limited landmarks or barriers, 1.35 times more likely to use the AHS in the afternoon compared with the morning, or when they are younger visitors (adjusted odds ratio, 1.47; 95% CI, 1.09-1.97). Individuals in a group are more likely (adjusted odds ratio, 1.39; 95% CI, 1.06-1.84) to use AHS.
  
  
  CONCLUSIONS
  In addition to location, time of day, and age, there is a group effect that results in visitors being more likely to use AHS when in a group. The increased use related to groups may serve as a mechanism to encourage visitor HH.
  
  
  CONCLUSIONS
  The results suggest future research opportunities to investigate the effect of group dynamics and social pressure on visitor AHS use and to identify strategies for improving visitor HH.
authors.affiliation: Department of Industrial Engineering, Clemson University, Clemson, SC.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Hobbs
authors.affiliation: Department of Industrial Engineering, Clemson University, Clemson, SC.
authors.forename: Susan
authors.initials: S
authors.lastname: Robinson
authors.affiliation: Department of Industrial Engineering, Clemson University, Clemson, SC. Electronic address: dneyens@clemson.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Neyens
authors.affiliation: Department of Infection Prevention and Control, Greenville Health System, Greenville, SC.
authors.forename: Connie
authors.initials: C
authors.lastname: Steed
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000438:Alcohols / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004202:Disinfectants / Q000008:administration & dosage*; D004203:Disinfection / Q000706:statistics & numerical data*; D005260:Female; D019983:Guideline Adherence; D064548:Hand Sanitizers; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D014789:Visitors to Patients; D055815:Young Adult
chemical_list: D000438:Alcohols; D004202:Disinfectants; D064548:Hand Sanitizers
keywords: Compliance; Hand hygiene; Infection control