Mechanical Hand dryers at clinical staff sinks

[Anonymous]

Has anybody had any experience with installation of hand dryers (warm
blowing air) in clinical areas?
We are building a new facility, the question has been raised can we
install hand dryers instead of paper towel in clinical areas at the hand
washing sinks?
Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Helping Everyone To Be And Stay Healthy

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[Maree Sommerville]

Dear Lyn,

Our neonatal unit considered hand dryers as an option to paper towels a
couple of years ago.

The 2 issues that we raised were uncontrolled air dispersal and the
noise factor (and they are so noisy…. Imagine hearing the hum of
dryers all day….)

To choose a dryer in a clinical setting would very much depend on that
setting.

In our neonatal nursery, the hand basins are within the ward, we have
carpeted floors, and the dryers potentially could disperse hand bacteria
and, depending on design, could disperse bacteria lurking in the carpet.

My organisation adopted a paper recycling process for the paper towels.

Hand dryers are relegated to public areas and not clinical ones.

* The NSW hand hygiene policy directive states ‘no hand dryers’.

http://www0.health.nsw.gov.au/policies/pd/2010/pdf/PD2010_058.pdf

* A study funded by Dyson (hand dryer company) supports their
claims that their product is superior to other hand dryers however they
are noisy.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017747/

* HHA have a ‘sample hand hygiene procedure’ that includes the
possibility of using a hand dryer

http://www.hha.org.au/UserFiles/file/Manual/Generic%20Hand%20Hygiene%20G
uidelines_final%20_4_.pdf

I wish you the best in making a final decision.

Maree Sommerville

Infection Control Coordinator

Mercy Hospital for Women

________________________________

Behalf Of Lyn A. Golden

Has anybody had any experience with installation of hand dryers (warm
blowing air) in clinical areas?
We are building a new facility, the question has been raised can we
install hand dryers instead of paper towel in clinical areas at the hand
washing sinks?

Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Helping Everyone To Be And Stay Healthy

must not disclose or use the information in this e-mail if you are not
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[Michael Wishart]

Hi Lyn

Apart from the possible air disruption / bacterial dispersion issues, there has been some discussion in the past about the speed and efficiency of electric hand driers in clinical areas. You would need to ensure you were not setting up your staff for longer drying times (or even worse, less adequate drying because it takes too long), and also increased skin care issues for staff due to excessive drying of the skin. If you do decide to support electric hand dryers in clinical areas, I would really encourage you to propose a solid trial phase and review the impact on both hand hygiene practices (are staff discouraged from hand hygiene with soap and water because of the dryers?) and also impact on staff skin integrity.

Good luck with whichever decision is made.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Thursday, 13 June 2013 9:33 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mechanical Hand dryers at clinical staff sinks

Dear Lyn,
Our neonatal unit considered hand dryers as an option to paper towels a couple of years ago.
The 2 issues that we raised were uncontrolled air dispersal and the noise factor (and they are so noisy. Imagine hearing the hum of dryers all day.)
To choose a dryer in a clinical setting would very much depend on that setting.
In our neonatal nursery, the hand basins are within the ward, we have carpeted floors, and the dryers potentially could disperse hand bacteria and, depending on design, could disperse bacteria lurking in the carpet.
My organisation adopted a paper recycling process for the paper towels.
Hand dryers are relegated to public areas and not clinical ones.

The NSW hand hygiene policy directive states no hand dryers.
http://www0.health.nsw.gov.au/policies/pd/2010/pdf/PD2010_058.pdf

A study funded by Dyson (hand dryer company) supports their claims that their product is superior to other hand dryers however they are noisy.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017747/

HHA have a sample hand hygiene procedure that includes the possibility of using a hand dryer
http://www.hha.org.au/UserFiles/file/Manual/Generic%20Hand%20Hygiene%20Guidelines_final%20_4_.pdf

I wish you the best in making a final decision.

Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women
________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Lyn A. Golden
Sent: Wednesday, 12 June 2013 4:34 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Mechanical Hand dryers at clinical staff sinks

Has anybody had any experience with installation of hand dryers (warm blowing air) in clinical areas?
We are building a new facility, the question has been raised can we install hand dryers instead of paper towel in clinical areas at the hand washing sinks?

Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Phone: 54855340
Fax: 54855390
E-mail: lgolden@erh.org.au

Helping Everyone To Be And Stay Healthy

DISCLAIMER: This e-mail and any attachments may be confidential. You must not disclose or use the information in this e-mail if you are not the intended recipient. If you have received this e-mail in error, please notify us immediately and delete the e-mail and all copies. Echuca Regional Health does not guarantee that this e-mail is virus or error free. The attached files are provided and may only be used on the basis that the user assumes all responsibility for any loss, damage or consequence resulting directly or indirectly from the use of the attached files, whether caused by the negligence of the sender or not. The content and opinions in this e-mail are not necessarily those of Echuca Regional Health.

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[RUSSO, Philip]

Hi Lyn

We have recently released the latest version of the Hand Hygiene
Australia Manual.

http://www.hha.org.au/UserFiles/file/Manual/HHAManual_2010-11-23.pdf

In Section 3.2 we state:

Both soap and ABHR products are necessary for the introduction of a HH
program;

a soap and water wash is required if hands are visibly soiled, and
either product

can be used if hands are visibly clean. As wet hands can more readily
acquire and spread microorganisms, the proper drying of hands is an
integral part of routine

hand hygiene (1).

Paper towels, cloth towels, and air dryers are commonly used to dry
washed hands. There is currently conflicting evidence as to the
efficacy of each method for removing bacteria from washed hands (23-25).
Ideally, hands should be dried using either individual paper towels, or
hand driers which can dry hands as effectively and as quickly as it can
be done with paper towels (26). Hand driers used in healthcare should be
proven not to be associated with the aerosolisation of pathogens (1),
for example using hospital grade HEPA filtration to minimise airborne
microorganisms (27).

(References are listed in the manual)

I would also support Maries comments regarding noise (day and night),
and also add that regular cleaning and maintenance of these machines
must also be considered.

Hope this helps your decision.

Kind regards
Phil Russo, M.Clin.Epid
Hand Hygiene Australia
National Project Manager
P: +61 3 9496 3587 | M: +61 411 659 486 |E: philip.russo@austin.org.au
http://www.hha.org.au/
Hand Hygiene Australia, c/- Austin Health Infectious Diseases Dept. PO
5555 Heidelberg, VIC, Australia 3084

Behalf Of Lyn A. Golden

Has anybody had any experience with installation of hand dryers (warm
blowing air) in clinical areas?
We are building a new facility, the question has been raised can we
install hand dryers instead of paper towel in clinical areas at the hand
washing sinks?

Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Helping Everyone To Be And Stay Healthy

must not disclose or use the information in this e-mail if you are not
the intended recipient. If you have received this e-mail in error,
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[Glenys Harrington]

Hi Lyn,

My understanding is that they are too noisy for clinical areas particularly
at night.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

H: +61 3 96902216

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Lyn A. Golden
sinks

Has anybody had any experience with installation of hand dryers (warm
blowing air) in clinical areas?
We are building a new facility, the question has been raised can we install
hand dryers instead of paper towel in clinical areas at the hand washing
sinks?

Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Helping Everyone To Be And Stay Healthy

not disclose or use the information in this e-mail if you are not the
intended recipient. If you have received this e-mail in error, please notify
us immediately and delete the e-mail and all copies. Echuca Regional Health
does not guarantee that this e-mail is virus or error free. The attached
files are provided and may only be used on the basis that the user assumes
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[Judy Forrest]

From my experience, many facilities I have been to actually turn off the hand dryers at night because they are too noisy. The question has to then be asked ….how do they dry their hands? On their uniforms?

Kind Regards
Judy Forrest
RN,CIC (Syd Hosp), Grad Cert. (Communicable Diseases), FCN, CPM FAAPM
Managing Director
[High Res – Screen]
Bug Control (Aust) Pty Ltd
Infection Control Advisory Service
PO Box 406 GORDON NSW 2072 Australia

Bug Control New Zealand Ltd
Infection Control Advisory Service
PO Box 42024 Tower Junction CHRISTCHURCH New Zealand

Providing Comprehensive Infection Prevention and Control Service for Healthcare, Emergency Services, Residential Care, Children’s Services, Cleaning, Catering and Laundry Services

This communication is confidential, and /or privileged and is intended only for the addressee. If you are not the intended recipient you must not copy, distribute, take any action in relation to it or disclose it to anyone. Any confidentiality or privilege is not waived because this email has been sent to you in error. Bug Control Aust Pty Ltd and Bug Control New Zealand Ltd are not responsible for any information not related to the business of Bug Control. If you have received this email in error, please notify the sender and destroy the email. Bug Control Aust Pty Ltd and Bug control New Zealand Ltd does not warrant that this email or its attachments are virus free. Please check it with a virus scanner before opening.

Hi Lyn,

My understanding is that they are too noisy for clinical areas particularly at night.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Has anybody had any experience with installation of hand dryers (warm blowing air) in clinical areas?
We are building a new facility, the question has been raised can we install hand dryers instead of paper towel in clinical areas at the hand washing sinks?

Does anyone have any thoughts on this?

Lyn

Infection Prevention and Control Manager

Echuca Regional Health
17 Francis Street
Echuca 3564

Helping Everyone To Be And Stay Healthy

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

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[Gill Wheaton]

Our experience here was that nurses in the clinical setting stated they
do not have time to stand and air dry their hands and we have re-
installed paper dispensers.
Regards

Gill Wheaton
Peri-operative Services Manager
St John of God Hospital
136 Botanic Road (PO Box 316)
Warrnambool 3280

>>> Judy Forrest 20/06/13 8:51 AM >>>

From my experience, many facilities I have been to actually turn off
the hand dryers at night because they are too noisy. The question has
to then be asked .how do they dry their hands? On their uniforms?

Kind Regards
Judy Forrest
RN,CIC (Syd Hosp), Grad Cert. (Communicable Diseases), FCN, CPM FAAPM
Managing Director

Bug Control (Aust) Pty Ltd
Infection Control Advisory Service
PO Box 406 GORDON NSW 2072 Australia
Bug Control New Zealand Ltd
Infection Control Advisory Service
PO Box 42024 Tower Junction CHRISTCHURCH New Zealand
Providing Comprehensive Infection Prevention and Control Service for
Healthcare, Emergency Services, Residential Care, Children’s Services,
Cleaning, Catering and Laundry Services
This communication is confidential, and /or privileged and is intended
only for the addressee. If you are not the intended recipient you must
not copy, distribute, take any action in relation to it or disclose it
to anyone. Any confidentiality or privilege is not waived because this
email has been sent to you in error. Bug Control Aust Pty Ltd and Bug
Control New Zealand Ltd are not responsible for any information not
related to the business of Bug Control. If you have received this email
in error, please notify the sender and destroy the email. Bug Control
Aust Pty Ltd and Bug control New Zealand Ltd does not warrant that this
email or its attachments are virus free. Please check it with a virus
scanner before opening.

Behalf Of Glenys Harrington

Hi Lyn,
My understanding is that they are too noisy for clinical areas
particularly at night.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Behalf Of Lyn A. Golden
staff sinks

Has anybody had any experience with installation of hand dryers (warm
blowing air) in clinical areas?
We are building a new facility, the question has been raised can we
install hand dryers instead of paper towel in clinical areas at the hand
washing sinks?
Does anyone have any thoughts on this?
Lyn
Infection Prevention and Control Manager
Echuca Regional Health
17 Francis Street
Echuca 3564
Helping Everyone To Be And Stay Healthy
must not disclose or use the information in this e-mail if you are not
the intended recipient. If you have received this e-mail in error,
please notify us immediately and delete the e-mail and all copies.
Echuca Regional Health does not guarantee that this e-mail is virus or
error free. The attached files are provided and may only be used on the
basis that the user assumes all responsibility for any loss, damage or
consequence resulting directly or indirectly from the use of the
attached files, whether caused by the negligence of the sender or not.
The content and opinions in this e-mail are not necessarily those of
Echuca Regional Health.
Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of ACIPC.
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[Gerald Cha]

Hi Lyn,
I’ve recently reviewed the proposed use of “ultra-rapid” hand dryers for my hospital for clinical areas (my comments are thus specific to this area and do not cover its use in general public areas such as public toilets, etc).
The use of HEPA filter filtration for the new hand dryers has to be seen in the proper context…
If the machine (“ultra-rapid” discussed here and not the conventional hand dryers) produces high velocity filtered air within a small confined area, that air needs to have an avenue to be exhausted out otherwise it gets channeled back at the user’s face (this based on the current “hands facing downwards” design)… thus the sides to the machine are left exposed to allow air (with water droplets from the user’s hands) to be channeled away from the user.
This would result in potential contamination of the immediate area surrounding the hand dryer (floor, wall, etc.) as water from the user’s hands gets aerosolised or propelled off.
The HEPA filtration in the dryer filters the propelled air but not the air that gets exhausted post contact with the user’s hands to the surrounding environment (so if you get users with extremely bad hand washing techniques i.e. no soap used post contact with gastro patient… this will then be an issue in a clinical environment).
Some studies such as:
Comparative evaluation of the hygienic efficacy of an ultra-rapid hand dryer vs conventional warm air hand dryers. (English) By: Snelling AM; Saville T; Stevens D; Beggs CB, Journal Of Applied Microbiology [J Appl Microbiol], ISSN: 1365-2672, 2011 Jan; Vol. 110 (1), pp. 19-26; PMID: 20887403
speak favorably regarding the new “ultra-rapid” hand dryers (kindly note that the study was funded by Dyson Limited, Malmesbury, UK.).
A comparative study of different hand drying methods: paper towel, warm air dryer, jet air dryer (2009). By: Redway K & Fawdar S. School of Biosciences, University of Westminster, London.

compared paper towels vs conventional warm air dryers vs the newer “ultra rapid” hand dryers and found paper towels to be the superior option (also note that this study was sponsored by the European Tissue Symposium (ETS) Brussels).
The Mayo Clinic did an extensive review of current evidence in 2012:
The hygienic efficacy of different hand-drying methods: a review of the evidence. (English) By: Huang C; Ma W; Stack S, Mayo Clinic Proceedings. Mayo Clinic [Mayo Clin Proc], ISSN: 1942-5546, 2012 Aug; Vol. 87 (8), pp. 791-8; PMID: 22656243
and is a great read as you explore the various options available.
Hope that helps and all the best with your hospital’s final decision to the matter.
Kind regards,
Gerald

Gerald Chan
Coordinator Infection Control

St John of God Murdoch Hospital
100 Murdoch Drive
MURDOCH. WA 6150

P: 9366 1552
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>>> Glenys Harrington 19/06/2013 6:06 PM >>>

Hi Lyn,
My understanding is that they are too noisy for clinical areas particularly at night.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Has anybody had any experience with installation of hand dryers (warm blowing air) in clinical areas?
We are building a new facility, the question has been raised can we install hand dryers instead of paper towel in clinical areas at the hand washing sinks?
Does anyone have any thoughts on this?
Lyn
Infection Prevention and Control Manager
Echuca Regional Health
17 Francis Street
Echuca 3564
Helping Everyone To Be And Stay Healthy
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