Giving health care workers easy access to alcohol-based handrubs can improve hygiene in hospitals, a study published today in the Online Open Access journal Critical Care suggests.

Good hand hygiene among health care workers can help minimise the spread of infections within hospitals. Alcohol-based handrubs are the standard method of hand hygiene worldwide, yet compliance amongst hospital staff remains low.

One of the best ways to boost compliance is to give workers bottles of handrub to keep in their pockets, report Prof Didier Pittet and colleagues from the University of Geneva Hospitals, Switzerland, who monitored the hand hygiene of 102 health care workers based in the same intensive care unit. Using a gel, rather than liquid-based product also made hand hygiene more acceptable and was reported to improve the skin condition of workers' hands.

The workers were first given access to a liquid-based handrub, which was then switched a few months later to a gel-based formulation of the same product. An independent observer recorded opportunities for hand hygiene and actual hand cleansing.

Overall compliance was low, with nurses most likely to follow hand hygiene recommendations compared to doctors. When the gel was introduced, compliance increased from 32% to 41%. But making the handrub immediately available generated the biggest increase in compliance - a jump of 15%.

Some hand hygiene measures have previously been found to cause skin irritation and more than half the health care workers in the study reported they preferred the gel to the liquid-based product, indicating that it improved the condition of their skin. No cases of significant skin damage occurred with either formulation of the handrub. Alongside availability, improved skin tolerance is an important factor in trying to persuade health care workers to take the necessary steps to improve hand hygiene.

Liquid versus gel handrub formulation: a prospective intervention study
Ousmane Traore, Stephane Hugonnet, Jann Lubbe, William Griffiths and Didier Pittet
Critical Care
www.ccforum

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