Giving the tap the elbow? An observational study
Hand washing is viewed as the most important barrier to cross infection. Incorrect use of clinical hand wash basins may lead to cross infection either from contaminated water or due to failure to decontaminate hands. Elbow operated taps used correctly prevent re-contamination of hands during operation. Observation shows many elbow operated taps are installed incorrectly with the handle flush with the back panel making it difficult to open using the elbow. AIM: To determine the effect of altering the angle of the handle of elbow operated taps on hand washing technique. METHODS: We conducted an observational study using two rooms; in one the handles of the elbow operated taps were flush with the inspection panel behind, and in the other they were set at 350. FINDINGS: 35 staff members washed their hands in both rooms. Hands were used to turn on the taps in 97% of instances. In 57% of washes hands were re-contaminated when used to turn the tap off. Only 6 individuals consistently used their elbows to turn outlets off. Surprisingly more individuals used their elbows to operate taps whose handles were flush with the inspection panel behind. CONCLUSION: Greater emphasis needs to be placed on correct use of elbow operated outlets. The decision to use elbow or sensor operated outlets is not clear cut as each has pros and cons. There is much room for improvement in design and standardisation of hand wash basins. Given the importance of hand washing it is surprising these gaps exist.