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Introduction of a Waterless Alcohol-Based Hand Rub in a Long-Term–Care Facility

Published online by Cambridge University Press:  02 January 2015

Lona Mody ,
Shelly A. McNeil ,
Rongjun Sun ,
Suzanne F. Bradley  and
Carol A. Kauffman
Lona Mody*
Affiliation:
Division of Geriatric Medicine, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan
Shelly A. McNeil
Affiliation:
Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan
Rongjun Sun
Affiliation:
University of Michigan Institute of Gerontology, Ann Arbor, Michigan
Suzanne F. Bradley
Affiliation:
Division of Geriatric Medicine, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan
Carol A. Kauffman
Affiliation:
Division of Infectious Diseases, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan
*
11 G, GRECC, VA Ann Arbor Healthcare System, 2215 Fuller Rd., Ann Arbor, MI 48105
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Abstract

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 soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.

Results:

Hand hygiene practices, knowledge, and opinions did not change after the educational or rub intervention. Ward A HCWs thought that the rub was faster (P = .002) and less drying (P = .04) than soap. Hand hygiene frequency did not differ at baseline between the two floors, but increased on ward A by the end of the study (P = .04). HCWs were colonized frequently with GNB (66%), Candida (41%), S. aureus (20%), and VRE (9%). Although colonization did not change from baseline on either ward, the rub was more effective in clearing GNB (P = .03) and S. aureus (P = .003). Nosocomial infection rates did not change.

Conclusion:

The alcohol-based hand rub was a faster, more convenient, less drying method of hand hygiene for HCWs in an LTCF, and it improved compliance. Although microbial colonization did not change, the rub was more efficacious in removing pathogens already present on the hands of HCWs.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 3 , March 2003 , pp. 165 - 171
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1.Othersen, MJ, Othersen, HB. A history of hand washing: seven hundred years at a snail's pace. The Pharos 1987;50:23–27.Google Scholar
2.Bauer, TM, Ofner, E, Just, HM, Just, H, Daschner, FD. An epidemiological study assessing the relative importance of airborne and direct contact transmission of microorganisms in a medical intensive care unit. J Hosp Infect 1990;15:301–309.Google Scholar
3.Voss, A, Widmer, AF. No time for handwashing? Handwashing versus alcoholic rub: can we afford 100% compliance? Infect Control Hosp Epidemiol 1997;18:205–208.Google Scholar
4.Larson, E. A causal link between handwashing and risk of infection? Examination of the evidence. Infect Control Hosp Epidemiol 1988;9:28–36.Google Scholar
5.Thompson, BL, Dwyer, DM, Ussery, XT, Denman, S, Vacek, P, Schwartz, B. Handwashing and glove use in a long-term-care facility. Infect Control Hosp Epidemiol 1997;18:97–103.CrossRefGoogle ScholarPubMed
6.Pittet, D, Mourouga, RPerneger, T. Compliance with handwashing in a teaching hospital. Ann Intern Med 1999;130:126–130.CrossRefGoogle ScholarPubMed
7.Meengs, MR, Giles, BK, Chisholm, GD, Cordell, WH, Nelson, DR. Handwashing frequency in an emergency department. Ann Emerg Med 1994;23:1307–1312.CrossRefGoogle ScholarPubMed
8.Albert, RK, Condie, F. Handwashing patterns in medical intensive care units. N Engl J Med 1981;304:1465–1466.Google Scholar
9.Graham, M. Frequency and duration of handwashing in an intensive care unit. Am J Infect Control 1990;18:78–81.CrossRefGoogle Scholar
10.Dubbert, PM, Doice, J, Richter, W, Miller, M, Chapman, SW. Increasing ICU staff handwashing: effects of education and group feedback. Infect Control Hosp Epidemiol 1990;11:191–193.Google Scholar
11.Simmons, B, Bryant, J, Neiman, K, Spencer, L, Arheart, K. The role of handwashing in prevention of endemic intensive care unit infections. Infect Control Hosp Epidemiol 1990;11:589–594.Google Scholar
12.Larson, E, Killien, M. Factors influencing handwashing behavior of patient care personnel. Am J Infect Control 1982;10:93–99.Google Scholar
13.Bischoff, WE, Reynold, TM, Sessler, CN, Edmond, MB, Wenzel, RRHandwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med 2000;160:1017–1021.Google Scholar
14.Pittet, D, Hugonnet, S, Harbarth, S, et al.Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet 2000;356:1307–1312.CrossRefGoogle ScholarPubMed
15.Nicolle, LE, Strausbaugh, LJ, Garibadi, RA. Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev 1996;9:1–17.Google Scholar
16.Vernon, MO, Trick, WE, Peterson, BJ, et al.Sustained increase in hand hygiene associated with decreased antimicrobial resistance in a long term care facility. Presented at the 39th Annual Meeting of the Infectious Diseases Society of America; October 25-28, 2001; San Francisco, CA. Abstract 249.Google Scholar
17.McGeer, A, Campbell, B, Emori, TG, et al.Definitions of infection for surveillance in long-term care facilities. Am J Infect Control 1991;19:1–7.CrossRefGoogle ScholarPubMed
18.Strausbaugh, LJ, Sewell, DL, Tjoelker, RC, et al.Comparison of three methods for recovery of yeasts from hands of health-care workers. J Clin Microbiol 1996;34:471–473.Google Scholar
19.Larson, EL, Brayn, JL, Adler, L, Blane, C. A multifaceted approach to changing handwashing behavior. Am J Infect Control 1997;25:3–10.CrossRefGoogle ScholarPubMed
20.Alvaran, MS, Butz, A, Larson, EL. Opinions, knowledge, and self reported practices related to infection control among nursing personnel in long-term care settings. Am J Infect Control 1994;22:367–370.Google Scholar
21.Broughall, JM, Marshman, C, Jackson, B, Bird, P. An automatic monitoring system for measuring handwashing frequency in hospital wards. J Hosp Infect 1984;5:447–453.Google Scholar
22.Wingard, E, Shlaes, JH, Mortimer, EA, Shlaes, DM. Colonization and cross-colonization of nursing home patients with trimethoprim-resis-tant gram-negative bacilli. Clin Infect Dis 1993;16:75–81.Google Scholar