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Use of alcohol hand sanitizer as an infection control strategy in an acute care facility*

https://doi.org/10.1067/mic.2003.15Get rights and content

Abstract

Background: Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care, substantial morbidity and mortality, and excess costs. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of an alcohol gel hand sanitizer by caregivers on infection types and rates in an acute care facility. Patients were educated about the study through a poster on the unit, and teachable patients were given portable bottles of the alcohol hand gel for bedside use, along with an educational brochure explaining how and why to practice good hand hygiene. Methods: Infection rate and type data were collected in 1 unit of a 498-bed acute care facility for 16 months (February 2000 to May 2001). An alcohol gel hand sanitizer was provided and used by caregivers in the orthopedic surgical unit of the facility during this period. Results: The primary infection types (more than 80%) found were urinary tract (UTI) and surgical site (SSI) infections. Infection types and rates for the unit during the period the alcohol hand sanitizer (intervention) was used were compared with the infection types and rates for the same unit when the alcohol hand sanitizer was not used (baseline); the results demonstrated a 36.1% decrease in infection rates for the 10-month period that the hand sanitizer was used. Conclusion: This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program in acute care facilities. (Am J Infect Control 2003;31:109-16.)

Section snippets

Facility description

This study was performed in a 498-bed acute care facility with 1700 employees. The facility occupies a 6-story main building with 2-story wings. The first floor of the main building houses the offices; cafeteria; central supply; laboratory; the surgery, dialysis, emergency, radiology, medical records, and endoscopy departments; and the surgical intensive care unit. Average daily census is 300, and the infection control practitioner-to-patient ratio is 1:300.

Study design

This study was performed in the

Infection rates

The primary infection types (more than 80%) found were UTIs and SSIs. Comparison of the infection types and rates for the unit when the alcohol hand sanitizer (intervention) was used were compared with infection types and rates on the same unit when the alcohol hand sanitizer was not used (baseline); a 36.1% decrease in infection rates was demontrated during the 10-month period when the hand sanitizer was used. The infection data by month for the baseline and hand sanitizer period are provided

Discussion

Hand hygiene is considered to be the most important and effective infection control measure to prevent transmission of nosocomial pathogens in health care settings. The results of hospital-based studies, published between 1977 and 1995, on the impact of hand hygiene on the risk of nosocomial infection have been reviewed by Larson.17 However, compliance with handwashing procedures by health care workers has been, and continues to be, unacceptably low.2, 5, 6, 7, 8, 12 Because of the importance

Conclusion

The continued emergence and control difficulties with multidrug-resistant pathogens, such as methicillin-resistant S aureus, vancomycin-resistant enterococci, and extended spectrum β-lactamase-producing gram-negative bacilli, are major problems in acute care and long-term care facilities alike. Alcohol hand sanitizers have the greatest antimicrobial efficacy and speed of kill against these resistant pathogens and help improve compliance because they are convenient, quick to use, and gentle on

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