Currently submitted to: JMIR Human Factors
Date Submitted: Jul 29, 2026
Open Peer Review Period: Jul 30, 2026 - Sep 24, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Applicator vs. Wipes for Skin Antisepsis: A Human Factors Study of Aseptic Non‑Touch Technique (ANTT) Compliance
ABSTRACT
Background:
Infection prevention during skin antisepsis relies on adherence to aseptic non‑touch technique (ANTT®), including protection of key sites. Existing guidance focuses on antiseptic formulation, coverage, and contact time, with limited attention to product design and application method in supporting ANTT.
Objective:
To evaluate the impact of antiseptic product design and application method on adherence to ANTT and application time during simulated skin antisepsis.
Methods:
A comparative human factors simulated use study was conducted in simulated clinical environments at four US sites. Registered nurses experienced in skin antisepsis and routine ANTT use participated. Each participant applied three products, an applicator (BD ChloraPrep™), wipe A (3M™ SoluPrep™), and wipe B (PDI Prevantics®) across two predefined scenarios with randomized order. Outcomes included adherence to ANTT, application time relative to instructions for use, frequency and duration of accidental touch events, touch time (proportion of application time with finger to site contact), antiseptic solution delivery, and user reported confidence, usability, and preference.
Results:
Forty‑six nurses participated. Adherence to ANTT was higher with the applicator (26/46; 57%) than with wipe A (4/46; 9%) or wipe B (6/46; 13%). Adherence to the application time highest with wipe B (35/46; 76%), followed by the applicator (22/46; 48%) and wipe A (14/46; 30%). Accidental touch events were less frequent with the applicator (16/46; 35%) than with wipe A (42/46; 91%) or wipe B (40/46; 87%), and touch time accounted for a smaller proportion of application time with the applicator (9.21%) than with wipe A (84.38%) and wipe B (71.87%). In the controlled scenario, antiseptic solution delivery was higher with the applicator. Most participants (42/46; 91%) preferred the applicator.
Conclusions:
In this simulated use human factor study, differences were observed between antiseptic application methods across multiple ANTT‑related measures. The applicator was associated with higher adherence to ANTT and fewer accidental touch events, while adherence to IFU specified application time was highest with wipe B. These findings suggest that application format and human–device interaction may influence procedural performance, including adherence to ANTT and application time.
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