Efficacy of handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial |
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| Authors: | Emmanuelle Girou Sabrina Loyeau Patrick Legrand Fran?oise Oppein Christian Brun-Buisson |
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| Affiliation: | aInfection Control Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France, bMicrobiology Laboratory, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, cMedical Intensive Care Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris |
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| Abstract: | ObjectiveTo compare the efficacy of handrubbing with an alcohol based solution versus conventional handwashing with antiseptic soap in reducing hand contamination during routine patient care.DesignRandomised controlled trial during daily nursing sessions of 2 to 3 hours.SettingThree intensive care units in a French university hospital.Participants23 healthcare workers.InterventionsHandrubbing 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.ResultsWith 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 median duration of hand hygiene was 30 seconds in each group.ConclusionsDuring routine patient care handrubbing with an alcohol based solution is significantly more efficient in reducing hand contamination than handwashing with antiseptic soap. What is already known on this topicTo improve compliance with hand hygiene during patient care, handrubbing with an alcohol based solution has been proposed as a substitute for handwashing because of its rapid action and accessibilityExperimental studies show that handrubbing is at least as effective as medicated soap in reducing artificial contamination of handsMany healthcare workers still have reservations regarding its efficacy and are reluctant to use this techniqueWhat this study addsWhen used in routine practice, handrubbing with an alcohol based solution after contact with patients achieved a greater reduction in bacterial contamination of hands than conventional handwashing with medicated soap |
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