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

Summary 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 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 Conclusion Critical RSI inspection, assembling, lubricating and packing should be performed using either gloves or within 1 h of washing hands.