Hand Washing - Literature review Example

Petersburg, Russia. ?METHODS.Prospective surveillance of HH compliance, nosocomial colonization, and antibiotic administration was performed from January until June 2000. In February 2000, alcohol?based hand rub was provided for routine HH use. Eight weeks later, a quality improvement intervention was implemented, consisting of review of interim data, identification of opinion leaders, posting of colonization incidence rates, and regular feedback. Means of compliance, colonization, and antibiotic use were compared for periods before and after each intervention. ?RESULTS.

A total of 1,027 events requiring HH were observed. Compliance was 44.2% before the first intervention, 42.3% between interventions, and 48% after the second intervention. Use of alcohol rose from 15.2% of HH indications to 25.2% between interventions and 41.5% after the second intervention. The incidence of nosocomial colonization (per 1,000 patient?days) with Klebsiella pneumoniae was initially 21.5, decreased to 4.7, and then was 3.2 in the final period. Rates of antibiotic and device use also decreased. ?CONCLUSIONS.

HH may have increased slightly, but the largest effect was a switch from soap and water to alcohol, which may have been associated with decreased cross?transmission of Klebsiella, although this may have been confounded by lower device use. Alcohol?based antiseptic may be an improvement over current practices, but further research is required. Girou, E., Loyeau, S., Legrand, P., Opein, F., & Brun-Buisson, C. (2002). Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial.

BMJ, volume 325, p. 362 Objective: To compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care. Design: Randomised controlled trial during daily nursing sessions of 2 to 3 hours Setting: Three intensive care units in a French university hospital Participants: 23 healthcare workers Interventions: Handrubbing with alcohol based solution (n=12) or handwashing with antiseptic soap (n=11) when hand hygiene was indicated before and after patient care.

Imprints taken of fingertips and palm of dominant hand before and after hand hygiene procedure. Bacterial counts quantified blindly Main outcome measures: Bacterial reduction of hand contamination. Results: With handrubbing the median percentage reduction in bacterial contamination was significantly higher than with handwashing (83% v 58%, P=0.012), with a median difference in the percentage reduction of 26% (95% confidence interval 8% to 44%). The medianduration of hand hygiene was 30 seconds in each group.

Conclusions: During routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap. Mody, L., McNeil, S., Sun, R., Bradley, S. & Kauffman, C. (2003). Introduction of a Waterless Alcohol?Based Hand Rub in a Long?Term–Care Facility. Infection Control and Hospital Epidemiology, volume 24, number 3, pp. pp. 165-171 ?OBJECTIVE.To examine the impact of introduction of an alcohol?based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long?

term–care facility (LTCF). ?METHODS.Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to