Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study
Background: Handwashing (HW) by clinical staff is the single most important measure for preventing transmission of nosocomial infection (NI). The primary objectives of this study were to improve the motivation and awareness of the importance of HW practices among health care workers (HCWs) and to as...
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| Veröffentlicht in: | American journal of infection control 2002-10, Vol.30 (6), p.334-340 |
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| creator | Marena, Carlo Lodola, Lorenzo Zecca, Marco Bulgheroni, Anna Carretto, Edoardo Maserati, Renato Zambianchi, Luigina |
| description | Background: Handwashing (HW) by clinical staff is the single most important measure for preventing transmission of nosocomial infection (NI). The primary objectives of this study were to improve the motivation and awareness of the importance of HW practices among health care workers (HCWs) and to assess the effectiveness of a new chemical system in checking HW compliance. In addition, we evaluated the efficacy and tolerability of 2 soap solutions used during regular working hours by HCWs at our institution. Method: A preliminary short training course was performed to promote HW compliance and awareness. We chose 2 surgical wards at our 1200-bed teaching hospital. Sampling of hands was conducted weekly during routine activities of HCWs without advance warning. We used the staff list as a sampling frame to select subjects. Data were collected anonymously. On the basis of a crossover study design, a plain soap and one containing 4% chlorhexidine gluconate (CHG) were used alternatively in each ward for 4 consecutive months. Hand samples were evaluated with microbiologic cultures and with a commercially available kit that measures adenosine triphosphate (ATP) bioluminescence. As additional process indicators, we examined the amount of hand soap and CHG solution distributed and rate of NIs. Results: A total of 74 HCWs were evaluated for hand contamination. During the 4-month study, we found a significant reduction in colony-forming unit counts (P |
| doi_str_mv | 10.1067/mic.2002.125809 |
| format | Article |
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The primary objectives of this study were to improve the motivation and awareness of the importance of HW practices among health care workers (HCWs) and to assess the effectiveness of a new chemical system in checking HW compliance. In addition, we evaluated the efficacy and tolerability of 2 soap solutions used during regular working hours by HCWs at our institution. Method: A preliminary short training course was performed to promote HW compliance and awareness. We chose 2 surgical wards at our 1200-bed teaching hospital. Sampling of hands was conducted weekly during routine activities of HCWs without advance warning. We used the staff list as a sampling frame to select subjects. Data were collected anonymously. On the basis of a crossover study design, a plain soap and one containing 4% chlorhexidine gluconate (CHG) were used alternatively in each ward for 4 consecutive months. Hand samples were evaluated with microbiologic cultures and with a commercially available kit that measures adenosine triphosphate (ATP) bioluminescence. As additional process indicators, we examined the amount of hand soap and CHG solution distributed and rate of NIs. Results: A total of 74 HCWs were evaluated for hand contamination. During the 4-month study, we found a significant reduction in colony-forming unit counts (P <.008) and ATP levels (P <.002) compared with baseline values. The results showed a positive correlation (r = 0.68, P <.0001) between the microbial counts detected by standard culture and ATP levels measured with the commercial kit. Plain soap (P <.003) was more effective than CHG in reducing colony-forming unit counts among HCWs in the vascular surgery ward. We documented a reduction in the NI rate and an increase in the consumption of soap and paper towels. Conclusion: HW compliance improved during the study period among HCWs. The method to measure ATP bioluminescence is simple and easy to perform and provides reliable results within a few minutes of sampling hands. It can be used extensively to test HW compliance among HCWs. (Am J Infect Control 2002;30:334-40.)</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1067/mic.2002.125809</identifier><identifier>PMID: 12360141</identifier><language>eng</language><publisher>St. Louis, MO: Mosby, Inc</publisher><subject><![CDATA[Adenosine Triphosphate - metabolism ; Adult ; Anti-Infective Agents, Local - administration & dosage ; Anti-Infective Agents, Local - adverse effects ; Anti-Infective Agents, Local - pharmacology ; Biological and medical sciences ; Chlorhexidine - administration & dosage ; Chlorhexidine - adverse effects ; Chlorhexidine - analogs & derivatives ; Chlorhexidine - pharmacology ; Colony Count, Microbial ; Cross Infection - prevention & control ; Cross-Over Studies ; Drug Eruptions - etiology ; General aspects ; Guideline Adherence ; Hand Disinfection - methods ; Humans ; Incidence ; Infectious Disease Transmission, Professional-to-Patient - prevention & control ; Luminescent Measurements ; Male ; Medical sciences ; Middle Aged ; Personnel, Hospital - standards ; Planification. Prevention (methods). Intervention. Evaluation ; Practice Guidelines as Topic ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Reproducibility of Results ; Soaps - administration & dosage ; Soaps - adverse effects ; Soaps - pharmacology]]></subject><ispartof>American journal of infection control, 2002-10, Vol.30 (6), p.334-340</ispartof><rights>2002 Association for Professionals in Infection Control and Epidemiology, Inc</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-a2c436f002bb624349d0a07622c34d5e8785dd3b1574ad29d1e2c8adef38b6923</citedby><cites>FETCH-LOGICAL-c373t-a2c436f002bb624349d0a07622c34d5e8785dd3b1574ad29d1e2c8adef38b6923</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1067/mic.2002.125809$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13973445$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12360141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marena, Carlo</creatorcontrib><creatorcontrib>Lodola, Lorenzo</creatorcontrib><creatorcontrib>Zecca, Marco</creatorcontrib><creatorcontrib>Bulgheroni, Anna</creatorcontrib><creatorcontrib>Carretto, Edoardo</creatorcontrib><creatorcontrib>Maserati, Renato</creatorcontrib><creatorcontrib>Zambianchi, Luigina</creatorcontrib><title>Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>Background: Handwashing (HW) by clinical staff is the single most important measure for preventing transmission of nosocomial infection (NI). The primary objectives of this study were to improve the motivation and awareness of the importance of HW practices among health care workers (HCWs) and to assess the effectiveness of a new chemical system in checking HW compliance. In addition, we evaluated the efficacy and tolerability of 2 soap solutions used during regular working hours by HCWs at our institution. Method: A preliminary short training course was performed to promote HW compliance and awareness. We chose 2 surgical wards at our 1200-bed teaching hospital. Sampling of hands was conducted weekly during routine activities of HCWs without advance warning. We used the staff list as a sampling frame to select subjects. Data were collected anonymously. On the basis of a crossover study design, a plain soap and one containing 4% chlorhexidine gluconate (CHG) were used alternatively in each ward for 4 consecutive months. Hand samples were evaluated with microbiologic cultures and with a commercially available kit that measures adenosine triphosphate (ATP) bioluminescence. As additional process indicators, we examined the amount of hand soap and CHG solution distributed and rate of NIs. Results: A total of 74 HCWs were evaluated for hand contamination. During the 4-month study, we found a significant reduction in colony-forming unit counts (P <.008) and ATP levels (P <.002) compared with baseline values. The results showed a positive correlation (r = 0.68, P <.0001) between the microbial counts detected by standard culture and ATP levels measured with the commercial kit. Plain soap (P <.003) was more effective than CHG in reducing colony-forming unit counts among HCWs in the vascular surgery ward. We documented a reduction in the NI rate and an increase in the consumption of soap and paper towels. Conclusion: HW compliance improved during the study period among HCWs. The method to measure ATP bioluminescence is simple and easy to perform and provides reliable results within a few minutes of sampling hands. It can be used extensively to test HW compliance among HCWs. (Am J Infect Control 2002;30:334-40.)</description><subject>Adenosine Triphosphate - metabolism</subject><subject>Adult</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>Anti-Infective Agents, Local - adverse effects</subject><subject>Anti-Infective Agents, Local - pharmacology</subject><subject>Biological and medical sciences</subject><subject>Chlorhexidine - administration & dosage</subject><subject>Chlorhexidine - adverse effects</subject><subject>Chlorhexidine - analogs & derivatives</subject><subject>Chlorhexidine - pharmacology</subject><subject>Colony Count, Microbial</subject><subject>Cross Infection - prevention & control</subject><subject>Cross-Over Studies</subject><subject>Drug Eruptions - etiology</subject><subject>General aspects</subject><subject>Guideline Adherence</subject><subject>Hand Disinfection - methods</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infectious Disease Transmission, Professional-to-Patient - prevention & control</subject><subject>Luminescent Measurements</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Personnel, Hospital - standards</subject><subject>Planification. Prevention (methods). Intervention. Evaluation</subject><subject>Practice Guidelines as Topic</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Reproducibility of Results</subject><subject>Soaps - administration & dosage</subject><subject>Soaps - adverse effects</subject><subject>Soaps - pharmacology</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1v2zAQhomiQeM4nbsVXDrK4YdIid0CI00KBGiHZBYo8mSxkESDJ9vI3D9eujbgKRM5PO97dw8hXzhbcaaruzG4lWBMrLhQNTMfyIIrURVSGP2RLBg3utBKyWtyg_iHMWakVp_INRdSM17yBfl7jwiII0wzjR3t7eQPFvswbeg2WTcHB0gPYe6p6yFPswPNCM2_FNsQh7gJjo4w99Hjd_o7wRDGMNn0RhPgbpiRdimO1Oa2iFvIhXugOYsY95Aozjv_dkuuOjsgfD6_S_L64-Fl_VQ8_3r8ub5_Lpys5FxY4Uqpu3xt22pRytJ4ZlmlhXCy9Arqqlbey5arqrReGM9BuNp66GTdaiPkktydev_PT9A12xTGvGvDWXPU2eSzmqPO5qQzJ76eEttdO4K_8Gd_Gfh2BixmN12ykwt44aSpZFmqzJkTB_m-fYDUoAswOfAhZSmNj-HdJf4BfGyUQA</recordid><startdate>20021001</startdate><enddate>20021001</enddate><creator>Marena, Carlo</creator><creator>Lodola, Lorenzo</creator><creator>Zecca, Marco</creator><creator>Bulgheroni, Anna</creator><creator>Carretto, Edoardo</creator><creator>Maserati, Renato</creator><creator>Zambianchi, Luigina</creator><general>Mosby, Inc</general><general>Mosby</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20021001</creationdate><title>Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study</title><author>Marena, Carlo ; Lodola, Lorenzo ; Zecca, Marco ; Bulgheroni, Anna ; Carretto, Edoardo ; Maserati, Renato ; Zambianchi, Luigina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-a2c436f002bb624349d0a07622c34d5e8785dd3b1574ad29d1e2c8adef38b6923</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adenosine Triphosphate - metabolism</topic><topic>Adult</topic><topic>Anti-Infective Agents, Local - administration & dosage</topic><topic>Anti-Infective Agents, Local - adverse effects</topic><topic>Anti-Infective Agents, Local - pharmacology</topic><topic>Biological and medical sciences</topic><topic>Chlorhexidine - administration & dosage</topic><topic>Chlorhexidine - adverse effects</topic><topic>Chlorhexidine - analogs & derivatives</topic><topic>Chlorhexidine - pharmacology</topic><topic>Colony Count, Microbial</topic><topic>Cross Infection - prevention & control</topic><topic>Cross-Over Studies</topic><topic>Drug Eruptions - etiology</topic><topic>General aspects</topic><topic>Guideline Adherence</topic><topic>Hand Disinfection - methods</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infectious Disease Transmission, Professional-to-Patient - prevention & control</topic><topic>Luminescent Measurements</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Personnel, Hospital - standards</topic><topic>Planification. Prevention (methods). Intervention. Evaluation</topic><topic>Practice Guidelines as Topic</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Reproducibility of Results</topic><topic>Soaps - administration & dosage</topic><topic>Soaps - adverse effects</topic><topic>Soaps - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marena, Carlo</creatorcontrib><creatorcontrib>Lodola, Lorenzo</creatorcontrib><creatorcontrib>Zecca, Marco</creatorcontrib><creatorcontrib>Bulgheroni, Anna</creatorcontrib><creatorcontrib>Carretto, Edoardo</creatorcontrib><creatorcontrib>Maserati, Renato</creatorcontrib><creatorcontrib>Zambianchi, Luigina</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marena, Carlo</au><au>Lodola, Lorenzo</au><au>Zecca, Marco</au><au>Bulgheroni, Anna</au><au>Carretto, Edoardo</au><au>Maserati, Renato</au><au>Zambianchi, Luigina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2002-10-01</date><risdate>2002</risdate><volume>30</volume><issue>6</issue><spage>334</spage><epage>340</epage><pages>334-340</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>Background: Handwashing (HW) by clinical staff is the single most important measure for preventing transmission of nosocomial infection (NI). The primary objectives of this study were to improve the motivation and awareness of the importance of HW practices among health care workers (HCWs) and to assess the effectiveness of a new chemical system in checking HW compliance. In addition, we evaluated the efficacy and tolerability of 2 soap solutions used during regular working hours by HCWs at our institution. Method: A preliminary short training course was performed to promote HW compliance and awareness. We chose 2 surgical wards at our 1200-bed teaching hospital. Sampling of hands was conducted weekly during routine activities of HCWs without advance warning. We used the staff list as a sampling frame to select subjects. Data were collected anonymously. On the basis of a crossover study design, a plain soap and one containing 4% chlorhexidine gluconate (CHG) were used alternatively in each ward for 4 consecutive months. Hand samples were evaluated with microbiologic cultures and with a commercially available kit that measures adenosine triphosphate (ATP) bioluminescence. As additional process indicators, we examined the amount of hand soap and CHG solution distributed and rate of NIs. Results: A total of 74 HCWs were evaluated for hand contamination. During the 4-month study, we found a significant reduction in colony-forming unit counts (P <.008) and ATP levels (P <.002) compared with baseline values. The results showed a positive correlation (r = 0.68, P <.0001) between the microbial counts detected by standard culture and ATP levels measured with the commercial kit. Plain soap (P <.003) was more effective than CHG in reducing colony-forming unit counts among HCWs in the vascular surgery ward. We documented a reduction in the NI rate and an increase in the consumption of soap and paper towels. Conclusion: HW compliance improved during the study period among HCWs. The method to measure ATP bioluminescence is simple and easy to perform and provides reliable results within a few minutes of sampling hands. It can be used extensively to test HW compliance among HCWs. (Am J Infect Control 2002;30:334-40.)</abstract><cop>St. Louis, MO</cop><pub>Mosby, Inc</pub><pmid>12360141</pmid><doi>10.1067/mic.2002.125809</doi><tpages>7</tpages></addata></record> |
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| ispartof | American journal of infection control, 2002-10, Vol.30 (6), p.334-340 |
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| subjects | Adenosine Triphosphate - metabolism Adult Anti-Infective Agents, Local - administration & dosage Anti-Infective Agents, Local - adverse effects Anti-Infective Agents, Local - pharmacology Biological and medical sciences Chlorhexidine - administration & dosage Chlorhexidine - adverse effects Chlorhexidine - analogs & derivatives Chlorhexidine - pharmacology Colony Count, Microbial Cross Infection - prevention & control Cross-Over Studies Drug Eruptions - etiology General aspects Guideline Adherence Hand Disinfection - methods Humans Incidence Infectious Disease Transmission, Professional-to-Patient - prevention & control Luminescent Measurements Male Medical sciences Middle Aged Personnel, Hospital - standards Planification. Prevention (methods). Intervention. Evaluation Practice Guidelines as Topic Public health. Hygiene Public health. Hygiene-occupational medicine Reproducibility of Results Soaps - administration & dosage Soaps - adverse effects Soaps - pharmacology |
| title | Assessment of handwashing practices with chemical and microbiologic methods: Preliminary results from a prospective crossover study |
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