Healthcare-associated infection is a major cause of morbidity and mortality. Hand hygiene, such as handwashing and the use of alcohol-based handrubs by healthcare workers before and after seeing patients, is considered the single most effective way of reducing healthcare-associated infection. However, compliance with hand hygiene guidelines among healthcare workers has been poor, generally below 50%.1
Studies assessing the effectiveness of strategies to improve adherence to recommended hand hygiene practices have generally lacked scientific rigour.2 Nevertheless, alcohol-based hand rubs are emerging as a promising solution in the fight against healthcare-associated infection.
Alcohol-based Handrubs: The Pros
Alcohol- based hand rubs have several advantages over traditional handwashing with soap and water:
- More effective in reducing the number of germs on hands. See Figure 1 below.
- Require less time to use. Application of a handrub takes about 20 seconds. On the other hand, to wash their hands, a healthcare worker has to leave the patient’s bedside, go to a sink, wash and dry their hands, and then perform the next task, all of which could take a few minutes. Over the course of a day’s work, if a healthcare worker washed their hands according to recommended guideline, the total amount of time spent on handwashing could be considerable, up to about an hour per eight-hour shift.
- Act faster in killing bacteria.
- Can be made accessible near points of patient care. This could improve adherence to hand hygiene. See Figure 2 (below).
- Less hand irritation and dryness with repeated use, provided emollients and/or skin moisturizers are added to the formula.
Alcohol-Based Handrubs: The Cons
- Alcohol is flammable. Therefore, alcohol-based handrubs should be stored, used and disposed safely.
- Require reliable dispensers that deliver the correct amount of product.
- Possible allergic contact dermatitis, contact urticaria syndrome or hypersensitivity to alcohol or additives present in alcohol-based hand rubs (rare).
Alcohol-based hand rubs represent a major advance in infection prevention and control. Compared with handwashing, their application requires less time, acts faster, irritates hands less often, and may improve hand hygiene compliance and healthcare-associated infection rates. Hospitals should consider installing alcohol-based hand rub dispensers near points of patient care as part of a multimodal, multidisciplinary strategy to improve hand hygiene behaviour.
- Pittet D. Improving Adherence to Hand Hygiene Practice: A Multidisciplinary Approach. Emerging Infectious Diseases 2001; Vol. 7, No. 2.
- Gould D, Chudleigh JH, Moralejo D, Drey N. Interventions to improve hand hygiene compliance in patient care. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005186. DOI: 10.1002/14651858.CD005186.pub2
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