Use of alcohol hand rub (AHR) at ward entrances and use of soap and AHR by patients and visitors: a study in 27 wards in nine acute NHS trusts

Joanne Savage, Christopher Fuller, Sarah Besser, & Sheldon Stone, 'Use of alcohol hand rub (AHR) at ward entrances and use of soap and AHR by patients and visitors: a study in 27 wards in nine acute NHS trusts', Journal of Infection Prevention, Vol. 12(2), March 2011. The version of record is available at doi: 10.1177/1757177410381661 © The Authors 2010. Published by SAGE.Ward procurement of hand hygiene consumables is a proxy measure of hand hygiene compliance. The proportion of this due to use of alcohol hand rub (AHR) at ward entrances, and bedside use of consumables by patients and visitors, is unknown. Thirty-six hours of direct observation of bedside hand hygiene behaviours by healthcare workers (HCWs), patients and visitors on 27 wards in nine hospitals was undertaken. AHR containers from ten ward entrances were collected for four days. Mean daily volume used was compared with mean daily volume procured. Only 4% of bedside soap and AHR use was by visitors. Patients used neither. An average 21% (range 7—38%) of all AHR procured by wards was used at ward entrances. Non-HCW use of soap or AHR at the bedside is low. Ward entrance use of AHR is modest but varies. Hand hygiene intervention studies using consumables as an outcome should assess and adjust for such usage.Peer reviewe

Real-time HD Exchange Kinetics of Proteins from Buffered Aqueous Solution with Electrothermal Supercharging and Top-Down Tandem Mass Spectrometry

Electrothermal supercharging (ETS) with electrospray ionization produces highly charged protein ions from buffered aqueous solutions in which proteins have native folded structures. ETS increases the charge of ribonuclease A by 34% whereas only a 6% increase in charge occurs for a reduced alkylated form of this protein, which is unfolded and ~66% random coil in this solution. These results indicate that protein denaturation that occurs in the ESI droplets is the primary mechanism for ETS. ETS does not affect the extent of solution-phase hydrogen-deuterium exchange (HDX) that occurs for four proteins that have significantly different structures in solution, consistent with a droplet lifetime that is significantly shorter than observable rates of HDX. Rate constants for HDX of ubiquitin are obtained with a spatial resolution of ~1.3 residues with ETS and electron transfer dissociation of the 10+ charge-state using a single capillary containing a few μL of protein solution in which HDX continuously occurs. HDX protection at individual residues with ETS HDX is similar to that with reagent supercharging HDX and with solution phase NMR, indicating that the high spray potentials required to induce ETS do not lead to HD scrambling