Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments

D. M. Costa, L. K. O. Lopes, A. F. V. Tipple, R. B. Castillo, H. Hu, A. K. Deva, K. Vickery

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area. Aim: To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness. Methods: Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands. Findings: Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001). Conclusion: Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

LanguageEnglish
Pages348-352
Number of pages5
JournalJournal of Hospital Infection
Volume97
Issue number4
DOIs
Publication statusPublished - Dec 2017

Fingerprint

Hand Hygiene
Surgical Instruments
Hand Disinfection
Hand
Adenosine Triphosphate
Product Packaging
Culicidae
Proteins
Maintenance

Keywords

  • Colony count
  • Gloves
  • Hand hygiene
  • Microbial
  • Sterilization
  • Surgical instruments

Cite this

Costa, D. M. ; Lopes, L. K. O. ; Tipple, A. F. V. ; Castillo, R. B. ; Hu, H. ; Deva, A. K. ; Vickery, K. / Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments. In: Journal of Hospital Infection. 2017 ; Vol. 97, No. 4. pp. 348-352.
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Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments. / Costa, D. M.; Lopes, L. K. O.; Tipple, A. F. V.; Castillo, R. B.; Hu, H.; Deva, A. K.; Vickery, K.

In: Journal of Hospital Infection, Vol. 97, No. 4, 12.2017, p. 348-352.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effect of hand hygiene and glove use on cleanliness of reusable surgical instruments

AU - Costa, D. M.

AU - Lopes, L. K. O.

AU - Tipple, A. F. V.

AU - Castillo, R. B.

AU - Hu, H.

AU - Deva, A. K.

AU - Vickery, K.

PY - 2017/12

Y1 - 2017/12

N2 - Background: During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area. Aim: To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness. Methods: Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands. Findings: Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001). Conclusion: Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

AB - Background: During functionality testing and packaging of reusable surgical instruments (RSI) for sterilization, instruments are frequently touched. There is a lack of standards relating to hand hygiene frequency and use of gloves in the sterilizing service unit packing area. Aim: To determine the effect of hand hygiene and glove use on maintenance of RSI cleanliness. Methods: Following manual and automated cleaning, Halsted-mosquito forceps were assessed for adenosine triphosphate (ATP), protein and microbial contamination after handling with gloved and ungloved but washed hands using an ATP surface swab test, bicinchoninic acid assay, and standard culture plate/broth, respectively. Gram's stain was used to classify the isolates. RSI contamination was assessed immediately following and 1, 2, and 4 h after washing hands. Findings: Packing instruments with hands that had been unwashed for 2 or 4 h resulted in a significant increase in contaminating ATP when compared with all other treatment groups (P < 0.05). There was a significant correlation between the time since washing hands, the amount of ATP (r = 0.93; P ≤ 0.001), and the microbial load (r = 0.83; P ≤ 0.001) contaminating the forceps, where the longer the time the hands remained unwashed the higher the contamination. Significantly more contaminating protein was found on forceps handled with ungloved hands that had not been washed for 2 or 4 h (P < 0.001). Conclusion: Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.

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KW - Gloves

KW - Hand hygiene

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DO - 10.1016/j.jhin.2017.06.018

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