Handrubbing with an alcohol based solution reduced healthcare workers’ hand contamination more than handwashing with antiseptic soap
QUESTION: Is handrubbing with an alcohol based solution as effective as standard handwashing with antiseptic soap for reducing hand contamination during routine patient care?
Design
Randomised (unclear allocation concealment), blinded (outcome assessor), controlled trial with follow up immediately after patient care activities.
Setting
3 intensive care units in a university hospital in France.
Participants
23 permanent and temporary nurses and nursing assistants who volunteered to participate.
Intervention
12 healthcare workers were allocated to handrubbing with a waterless alcohol based solution (45% 2-propanol, 30% 1-propanol, 0.2% mecetronium ethyl sulphate, average 3–5 ml; Sterillium, Bode Chemie, Hamburg, Germany), and 11 were allocated to handwashing with antiseptic soap (chlorhexidine gluconate 4%; Hibiscrub, Zeneca Pharma). All participants had previously been instructed on the use of the alcohol based solution when a hospital-wide handrubbing policy was implemented 1 year previously. Each unit had a copy of the written protocol.
Patient care activities were monitored during daily sessions of 2–3 hours until a predetermined number of eligible activities (ie, direct contact with a patient’s skin before invasive care, after interruption of care, and after contact with any part of a patient that was colonised with multiresistant bacteria) had been performed. 1 session comprised 5 patient care activities that required hand hygiene before and after care. …
