
PullClean: Door handles as sanitizers - jasonrdsouza
http://www.pullclean.com/
======
muxxa
The handles on inward opening doors are a vector for bacteria because there is
no way of physically interacting with them without using your hands and
touching the same place as everyone else. This product does not solve this
problem, but instead tries to insert itself into the users' task flow at
precisely the time when their goals are focused elsewhere (on opening the
door). This is a rude interruption and will likely annoy rather than encourage
more sanitization. In the video (0:59), a woman sanitizes her hands then must
immediately compromise them again to actually open the door.

I'd prefer to see a handle designed for safe operation by the elbows or feet
so that the hands don't need to be compromised. Think of how a surgeon enters
an operating room by pushing the door with their shoulder and their hands held
up out of the way.

~~~
evanb
I've seen things along this line in restaurants before:

    
    
        http://footpull.com/

~~~
bradknowles
Doesn't work. That requires you to pull a door open with your feet, using the
strongest muscles in your body but in a way in which they are weakest.

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bitexploder
I am curious how this compares to:
[http://en.wikipedia.org/wiki/Antimicrobial_copper-
alloy_touc...](http://en.wikipedia.org/wiki/Antimicrobial_copper-
alloy_touch_surfaces)

These surfaces have good properties and don't encourage any sort of
resistances.

edit: I see Pull Clean is trying to get people to clean their hands more, but
I also think it is not good to ignore an existing good strategy for
eliminating germs in one of the dirtiest places (door handles) in a hospital.
I am wondering how well studied this is and if it results in a cleaner
environment in a hospital setting compared to installing the copper surface
handles everywhere.

~~~
sosuke
I came to mention something similar I read many years back about copper, but
it was funded by the "copper industry" and the article is on the Daily Mail
from 2008.

[http://www.dailymail.co.uk/health/article-1081359/Copper-
doo...](http://www.dailymail.co.uk/health/article-1081359/Copper-door-handles-
taps-kill-95-superbugs-hospitals.html)

Alternatively I found another article sighting a study that says brass is good
from 2012.

[http://www.telegraph.co.uk/health/healthnews/9762689/Fit-
bra...](http://www.telegraph.co.uk/health/healthnews/9762689/Fit-brass-
fixtures-to-cut-superbugs-say-scientists.html)

~~~
bitexploder
Now that I think about it... I wonder if you could combine pull clean with
copper/antimicrobial surfaces.

------
escapologybb
I also think that these kind of gels give a false sense of security, I have
anywhere up to four different carers coming through this house on any given
day using the stuff. And they do something that might be slightly medical in
nature, then it's a quick squirt of the gel and hey presto no more tiny stinky
biting things!

But that is absolutely NOT how they work, these gels are generally designed to
be used AFTER washing your hands and only work if you rub them in for up to 30
seconds. But I would be surprised if many people knew that, *II only knew that
because - and this is going to sound like total hyperbole - my life literally
depends upon people washing their hands.

I think it's really interesting that when doctors, nurses or any other medical
professionals come through they always wash your hands but carers always seem
to rely on the magic gel. People need education as well as these tools, not
instead of.

/Rant

~~~
skue
Can you provide references?

That may be true of your basic drugstore Purell, which just contains ethyl
alcohol. But the literature does indicate that hospital-grade hand sanitizers
(a blend of alcohols, and/or a non-alcohol equivalent) are far superior and
immediately effective against most organisms.

See for example,
[http://cmr.asm.org/content/17/4/863.short](http://cmr.asm.org/content/17/4/863.short)

~~~
escapologybb
No problem, from the CDC[0] report entitled "Guideline for Hand Hygiene in
Health-Care Settings"[1] From that reference it says, we have:

"Alcohols are not appropriate for use when hands are visibly dirty or
contaminated with proteinaceous materials." "Alcohols are rapidly germicidal
when applied to the skin, but they have no appreciable persistent (i.e.,
residual) activity." "Despite its effectiveness against these organisms,
alcohols have very poor activity against bacterial spores, protozoan oocysts,
and certain nonenveloped (nonlipophilic) viruses. Similarly, certain accepted
methods for evaluating waterless antiseptic agents for use as antiseptic hand
rubs require that 3 mL of alcohol be rubbed into the hands for 30 seconds,
followed by a repeat application for the same duration. This type of protocol
also does not reflect actual usage patterns among HCWs."

The alcohol gels are good, but I think they're not a cureall was my point.

[0]:[http://www.cdc.gov/](http://www.cdc.gov/)
[1]:[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm)

~~~
27182818284
>but I think they're not a cureall was my point.

I honestly don't know a single nurse / medical staff or even IT person in a
hospital or university that thinks they are, though. You might not be giving
people enough credit. Anecdotal, yes, but I've never seen people think of them
as a "cureall" or even as a replacement of washing hands. It is always in
addition or inbetween things where you can't get to a handwashing immediately
(e.g., candidates shaking hands) _shrug_

~~~
escapologybb
You're absolutely right, my evidence is anecdotal. But I'm 36 years old now,
and I've been in and out of hospital probably thousands of times and had
medical care each day in one form or another.

So yes, anecdotes for sure. But that's one hell of a lot of anecdotes. :-)

~~~
dragonwriter
The difference between anecdote and systematically gathered data to resolve a
question isn't one of how extensive the anecdote is, its about how
representative it is. (And, of course, there's other issues with anecdote
about what _other people think_ , since what that really is is is one persons
_inferences_ about what lots of other people think.)

~~~
escapologybb
Absolutely, and I would imagine that once I'd made my mind up about this there
was a fair degree of confirmation bias thrown in as well. Along with a whole
host of other Things One Mustn't Do When Collecting Trustworthy Data™.

------
bazzargh
Last time I visited a hospital, there were gel dispensers beside every single
door, already. I googled and those are under $10 for twice the capacity of the
PullClean... so 1 PullClean vs 20 wall-mounted dispensers?

I think they'd really have to have some studies showing the different
placement really made an impact for hospitals to buy this at scale.

~~~
cheald
Yeah, that was my thought, as well. Sanitizer dispensers are everywhere in
hospitals. You can't walk through a door without passing one. Staff habitually
sanitize on their way into a room, where they then put on sterile gloves to
interact with the patent, and then dispose of the gloves on their way out.

This looks like a solution in search of a problem.

~~~
corobo
Our local hospital has hand sanitizer dispensers that talk to you as you go
past them even "Have you washed your hands?" then light up sort of thing as
they detect movement

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seatonist
Is it just me, or is this a recipe for slippery sanitizer-covered floors after
people bump into these handles and trigger the pump? (Whether deliberately, by
opening the door with their backs with hands full, or inadvertently just
walking around in a crowded corridor.)

~~~
krallja
Please explain how you open a pull door with your back.

~~~
seatonist
Despite actually watching the video and reading the site, I was still kind of
visualizing a push door when I wrote this (whoops!) but I have definitely
hooked my elbow or shoulder into the right sort of pull doors if I'm carrying
a bunch of equipment, or bags, or something. Or, more likely, I'll brace the
equipment against the door and grab with a hand, then keep it open with a
foot. Raises the same issues with the dispenser.

In any case, I still think there is risk having this ambiguous button like
thing, both from passersby bumping it and from normal use. And, as my comment
(and the immortal Far Side comic) illustrates, many pull doors and push doors
look confusingly similar, so people _will_ push the pull handles.

Also, may I suggest making your correction in a friendlier way next time?
Especially because it is possible that the person you're correcting may not be
the total doofus you imagine them to be!

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alexvr
Clever idea, but I think I would prefer automatic doors and conveniently
located motion-sensing sanitizer dispensers. And as much as I like embedded
software, I don't think it's particularly useful or worthwhile in something
like this, with the exception of monitoring the amount of remaining sanitizer
in individual handles.

Also, from what I've heard, hand sanitizers aren't great for you. Placing them
on doors, encouraging (or perhaps pressuring) people to use them frequently,
might do more harm than good. It would be vastly more practical and effective
to strategically place motion-triggered sanitizer dispensers _after_ doors,
especially in patient rooms and on the way out of certain sections of the
hospital.

It's respectable that you're thinking outside the box and looking to solve a
real problem, but this needs more thought.

------
escapologybb
Here's a report[0] given to the Sheffield Trust Executive Group talking about
cystic fibrosis, one of the recommendations they made included:

"... bactericidal copper touch plates on doors and handles... "

For much the same reasons as other commenters have pointed out, they have
excellent antimicrobial properties. I'm moving into a new build at the moment,
and we're using copper for the very same reasons. Being quadriplegic,
infections are an absolute nightmare to get rid of so these things are going
to be invaluable.

[0]:[http://www.sth.nhs.uk/clientfiles/File/Enclosure%20I%20-%20C...](http://www.sth.nhs.uk/clientfiles/File/Enclosure%20I%20-%20Cystic%20Fibrosis%20Unit%20\(2\)%20%2012%20-%207%20-11.pdf)

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sp332
I didn't realize that I had to manually page through the slides at the top to
understand the product. I scrolled down and had no idea what the product was.
Might want to put that first instead of hidden on slide 4.

~~~
SloopJon
I still haven't figured it out (partially for lack of trying, I'll admit).
Kind of reminds me of Donald Norman's criticism of doors that require a user
manual, even if it's only one word.

------
brudgers
I get the sense that while well intentioned, the designer has not adequately
observed a full range of health care activities typical in many modern
hospitals. Those big swinging doors are big and swinging so that beds can
pushed through quickly in an emergency.

Because emergencies can occur anywhere, [e.g. a few years ago my sister-in-law
was a code blue in the CT-room -- and that's how the staff remembered her
following her recovery], doors and walls and everything below a certain height
must be designed for impact by a fast moving fully loaded hospital bed.

One of the reasons door handles are so big and bulky to begin with is that's
where they get hit, and they get hit to prevent damaging the door. Hospitals
place scrub sinks in alcoves and up high. Same with the typical hand-sanitizer
stations.

The other concern with the design is that it creates places for bacteria to
'hide' from cleaning - the seams and hinges of the door handle that allow
access for refills and that operate the dispensing mechanism. Of more concern
is that these are places where a health-care worker will place their hands and
that by incorporating these into an architectural specialty, they are not
disposable and require ongoing cleaning.

Monolithic is good. Anything that requires manipulation should fit in an
autoclave or be disposable.

------
markbnj
I also think this product is attempting to solve the wrong problem, in the
wrong way. Rather than try to insert another workflow step (as a previous
commenter ably put it) why not focus on ways of preventing the contact with
contaminants in the first place? After all, door handles are just one vector,
and how many of the others can be converted into sanitizer dispensers?

------
Yver
I might be an idiot but... how about automatic doors? (that you don't have to
touch)

You want some WiFi app thingie? Ok, link the automatic doors to the nearest
gel dispenser and when the ratio of door opening/dispenser use gets too low,
the door only opens after the dispenser has been used.

~~~
VLM
Big Brother class 0 is the automatic doors don't open till you sanitize
(connected over wifi). Or your phone/tablet disconnects from the wifi network
5 minutes after sanitization.

Big Brother class 1 is your smart wifi nametag displays how long its been
since you used hand sanitizer for everyone to read.

Big Brother class 2 is it also goes on your permanent record for review time
and of course malpractice lawsuit time via wifi.

~~~
0xdeadbeefbabe
Big Brother class 3 they kill the infected you and spin up a new instance.

------
0xdeadbeefbabe
What about my carefully cultivated habit of not touching the door? If I change
habits and start touching doors someday I'll mistakenly touch the wrong door.
If I mistakenly touch the wrong door I'll start spreading The Disease.

~~~
krallja
How do you open doors without touching them?

------
wf
I'm having a hard time remembering what it was but around this time last year
I saw someone demonstrating a sort of gel like cover (similar to this
[http://www.amazon.com/Cyber-Clean-25055-Office-Pop-
up/dp/B00...](http://www.amazon.com/Cyber-Clean-25055-Office-Pop-
up/dp/B00375JBL4)) at a startup weekend.

The idea was to cover door handles with it in hospitals etc and had received
positive feedback from quite a few local hospitals if I'm remembering
correctly. I'm not sure what happened to that project though. I like that
solution much better than this though.

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ja27
FDA approval / clearance is a nightmare. I think it took Vioguard 4+ years to
get it for their UV-sanitizing keyboard. You need to be connected, funded,
and/or patient.

[http://www.vioguard.com/](http://www.vioguard.com/)

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llamataboot
Is there any empirical research showing that placing sanitizer in door handles
(as opposed to next to the door, or in the hallway, or wherever- - most
hospitals have sanitizer everywhere) has an increase in use - especially for
caregivers?

~~~
nathannecro
Unsure. In the hospitals I've worked at, there are sanitizing stations mounted
either directly outside of any n-set of rooms (in ER's, they're mounted
outside every room). It's habit for any health personnel to sanitize on the
way in, rub a bit, wash hands at sink, and sanitize on the way out. In some
cases (should theoretically be all...but hey, we're lazy) we wash on the way
out as well.

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chdir
Slightly related: I wish door handles, taps, bathroom flushes, up/down lift
buttons etc. are mostly foot operated everywhere. There's really not much
advantage of interacting with all these knobs with your hands.

~~~
Malus
This doesn't work well for those who are wheelchair-bound or in crutches.

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the-goose
These handles wont qualify under the Americans with disabilities act. It needs
to be a lever now for the disabled.

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knowuh
Doors are a congestion area, and seem like exactly the wrong place to be doing
something like washing hands.

~~~
natch
Obviously stopping and standing there at the door is not the idea here.

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HNJohnC
Another solution in search of a problem. How about posts about truly
interesting things like beneficial microbial populations etc. The days of
"sanitizing" are rapidly coming to a close in the face of modern science.

~~~
DanBC
This is a baffling post.

Sanitizing is _more_ important because modern science is losing anti-biotics.

Hospital acquired infections kill a reasonable number of people and make quite
a few others miserable (vomiting bugs are not fun).

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hoopism
Stinks, they will only let me buy a max of 10. I wanted 100... guess I'll have
to look for something else.

