Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?

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Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?

Wojgani, H; Kehsa, C; Cloutman-Green, E; Gray, C; Gant, V; Klein, N; (2012) Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors? PLOS ONE , 7 (10) , Article e40171. 10.1371/journal.pone.0040171. Green open access

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Abstract

Objective To determine whether microbial contamination of door handles in two busy intensive care units and one high dependency unit was related to their design, location, and usage. Design Observational study of the number of viable bacteria on existing door handles of different design at defined entry/exit points with simultaneous data collection of who used these doors and how often. Setting Two busy specialised intensive care units and one high dependency unit in a tertiary referral NHS neurological hospital. Main outcome measures Surface bacterial density on door handles with reference to design, location, and intensity of use. Results We found a significant correlation between the frequency of movements through a door and the degree to which it was contaminated (p = <0.01). We further found that the door's location, design and mode of use all influenced contamination. When compared to push plate designs, pull handles revealed on average a five fold higher level of contamination; lever handles, however, displayed the highest levels of bacterial contamination when adjusted for frequency of use. We also observed differences in contamination levels at doors between clinical areas, particularly between the operating theatres and one of the ICUs. Conclusions Door handles in busy, “real life” high acuity clinical environments were variably contaminated with bacteria, and the number of bacteria found related to design, location, mode and frequency of operation. Largely ignored issues of handle and environmental design can support or undermine strategies designed to limit avoidable pathogen transmission, especially in locations designed to define “thresholds” and impose physical barriers to pathogen transmission between clinical areas. Developing a multidisciplinary approach beyond traditional boundaries for purposes of infection control may release hitherto unappreciated options and beneficial outcomes for the control of at least some hospital acquired infections.

Type:	Article
Title:	Hospital Door Handle Design and Their Contamination with Bacteria: A Real Life Observational Study. Are We Pulling against Closed Doors?
Open access status:	An open access version is available from UCL Discovery
DOI:	10.1371/journal.pone.0040171
Publisher version:	http://dx.doi.org/10.1371/journal.pone.0040171
Language:	English
Additional information:	© Wojgani et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This study was funded by the EPSRC through the Health and Care Research and Innovation Centre (HaCIRIC). Hedieh Wojgani is a HaCIRIC Research Fellow. Catherine Kesah was funded by the British Council through Foreign and Commonwealth Office Fellowship. Vanya Gant was partly funded by the UCLH Comprehensive Biomedical Research Centre.
UCL classification:	UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Civil, Environ and Geomatic Eng
URI:	https://discovery.ucl.ac.uk/id/eprint/1381837