the increase in bacterial antibiotic resistance is a serious problem , increasing both in severity and importance .
therefore , it is necessary to find means of limiting or even preventing the transmission of pathogens within medical facilities .
surfaces in patients surroundings , including the door knob or handle , are a relevant transmission route for viruses and microorganisms , , , .
hospital staff , visitors , cleaning services and others are a potential source of contamination for door handles . in particular , the nursing staff  with a hand - disinfection rate of under 50% ,    can spread pathogens , as can other employees , 4.6% of whom have been found to be colonized with mrsa .
one alternative to avoid this route of transmission is to equip doors with a foot - operated door opener rather than with a door handle .
a device for opening the door with the foot was fitted flush into the door leaf . a pedal ( figure 1 ( fig .
1 ) ) is integrated into the device , which is built into the bottom of the door leaf . to open the door ,
this pedal is pulled out with the foot from the inside of the device , while the foot constantly remains on the surface of the pedal .
after completely pulling the pedal out , the door can be pushed open or pulled open while keeping light pressure on the pedal with the foot .
the surface design of the pedal provides the necessary grip of the shoe on the pedal during the movement to be executed .
subsequently , the door will briefly remain in the open position before the door closer starts to pull the door back into its frame .
using the foot pedal alone , this device makes it possible to open the door without manual operation .
after opening of the door , there is ample time to pass through the open door .
the foot - operated door opener is optionally equipped with a soft - closing mechanism . as a result , while opening the door with the foot door opener , the door latch ( figure 1 ( fig .
1 ) ) will be kept inside the door lock by a mechanism integrated into the foot door opener . only after complete closing of the door ( i.e.
, the door is back in its frame ) is the door latch released by the mechanism : the door latch slowly and quietly returns to its normal position in the counterpart within the door frame .
the function of the door handle and the door lock itself is not affected . in both cases , opening with the door handle or foot - operated door opener , the door latch is triggered , which means a change in the mechanics of the normal door handle with its lock is not necessary .
only if the door lock itself is locked is it impossible to open the door with either the handle or   the foot door opener . equipped with the soft closing mechanism , the noise generated by the door latch hitting the door frame
is completely prevented , and the noise generated by the door latch quickly snapping back into its counterpart in the door frame is almost imperceptible . the foot door opener makes the door handle   superfluous in most cases .
in addition , the transport of items that must be carried with both hands , e.g. , trays , is facilitated .
another means of opening doors without using the hands is provided by door handles designed to be operated with the forearm . however
, this type of handle can still be operated by hand and is thus in danger of becoming contaminated . nevertheless , when used correctly , the forearm - operated door opener reduces the risk of cross - infection .
where door handles are coated with oligodynamic effective metals such as silver and copper in nanocrystalline form , the antimicrobial action takes effect only many hours later , and a false sense of security is produced .
based on unproven efficacy within a relevant exposure time , inactivation through protein loading , and the absence of evaluations on possible toxic risks , coating door handles with such compounds is not a reasonable alternative to the foot - operated door opener . if used correctly , the mechanical foot - operated door opener can completely avoid the transfer of pathogens .
additional advantages include : no electrical energy is necessary for operationno follow - up costs arise , e.g. , from consumablesthe functionality of the existing door lock is not compromised , andnothing protrudes from the plane of the door leaf .
no electrical energy is necessary for operation no follow - up costs arise , e.g. , from consumables the functionality of the existing door lock is not compromised , and nothing protrudes from the plane of the door leaf .
with the foot - operated door opener described here instead of the traditional manually operated door handle , it is possible to open doors with a foot pedal . contamination of door handles with pathogens is thus avoided .
stefan preiss is responsible for sales / production at sass - systeme gmbh axel kramer declares that he has no competing interests .
stefan preiss is responsible for sales / production at sass - systeme gmbh axel kramer declares that he has no competing interests .
 aim : as door handles represent a transmission route for viruses and micro - organisms , a door opening and closing mechanism should be developed without manual operation.method : to solve the problem , a device for opening the door with the help of a foot pedal was built into the door leaf.results : the design enables mechanical opening of the door with a foot pedal without manual operation . 
 subsequently , the door closes with the help of a mechanical locking mechanism.discussion : the foot - operated door opener constitutes an additional option to the door handle . together with the equipment of a soft closing mechanism , it is possible to prevent noise emanating from the door latch impinging on the door frame . using this construction , 
 the door handle as a transmission vector is eliminated . 
 in addition , the transport of goods held with two hands simultaneously is facilitated.conclusion : with a foot - operated door opener instead of the traditional manual door handle , it is possible to open doors with a foot pedal . 
 this prevents contamination of door handles with pathogens . 