Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness
Background The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated...
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| Veröffentlicht in: | American journal of infection control 2012-11, Vol.40 (9), p.800-805 |
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| creator | Chow, Angela, MD, MPH Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD Chan, Siew-Pang, PhD Poh, Bee-Fong, BSc Krishnan, Prabha, MD Ng, Woei-Kian, BSN, MSN Choudhury, Saugata, MD Chan, Joey, MD Ang, Brenda, MD, MPH |
| description | Background The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated. Methods We conducted a randomized controlled trial in the general wards of a 1,300-bed, acute, tertiary care hospital to compare the effectiveness of 3 hand hygiene protocols during routine inpatient care: (1) handrubbing with alcohol covering all hand surfaces, (2) handrubbing with alcohol using the standard 7-step technique, and (3) handwashing with chlorhexidine using the standard 7-step technique. Hand samples were obtained from 60 medical and 60 nursing staff, before and after hand hygiene. Quantitative and qualitative bacterial evaluations were carried out by microbiologists blinded to the protocol. Results All 3 protocols were effective in reducing hand bacterial load ( P < .01). During routine patient care, alcohol handrubbing covering all hand surfaces required less time (median, 26.0 seconds) than alcohol handrubbing using the 7-step technique (median 38.5 seconds; P = .04) and chlorhexidine handwashing (median, 75.5 seconds; P < .001). Conclusion Alcohol handrubbing protocols are as efficacious as chlorhexidine handwashing. Alcohol handrubbing covering all hand surfaces is the most time-effective protocol for routine patient care activities in busy general wards. |
| doi_str_mv | 10.1016/j.ajic.2011.10.005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1349698249</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0196655311012594</els_id><sourcerecordid>1349698249</sourcerecordid><originalsourceid>FETCH-LOGICAL-c568t-a0638712b45fa5875d14706145831c98926398a3aa59ccd72ab8a4877b40b8d73</originalsourceid><addsrcrecordid>eNqFkstu1DAUhiMEotPCC7BAkRBSNxl8iR0bVUijiptUiQWwthznhPGQxIOdFIbH4Uk5mZm2Uhewsa3zf-f35XeWPaNkSQmVrzZLu_FuyQilWFgSIh5kCypYVXCm5cNsQaiWhRSCn2SnKW0IIZpL8Tg7YYwzUXG6yP6sOhfWocvXdmjiVNd--JbjMnfrLsQ1_PKNH2Cv_rRpPavbGMbgQpfyNsQ8hmncEyFt_Wg7lK0bvYPX-SqP2BZ6_xvQr_ODd6iP0eMY2lufHNoWFbfb7zv6HuYKoMk1DJDSk-xRa7sET4_zWfb13dsvlx-Kq0_vP16urgonpBoLSyRXFWV1KVorVCUaWlZE0lIoTp1WmkmuleXWCu1cUzFbK1uqqqpLUqum4mfZ-cEXD_ZjgjSa3icHXWcHCFMylJdaasVK_X-UMikpU2J2fXEP3YQpDngRpEqtBVGMI8UOlIshpQit2Ubf27gzlJg5bLMxc9hmDnuuYdjY9PxoPdU9NLctN-ki8PII2IRP32Iczqc7Tgpdyb3RxYEDfN5rD9Ek52Fw0PiIOZgm-H-f48299puwv8MO0t19TWKGmM_zt5x_JUVDJnTJ_wI5uN3-</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1149950823</pqid></control><display><type>article</type><title>Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Chow, Angela, MD, MPH ; Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD ; Chan, Siew-Pang, PhD ; Poh, Bee-Fong, BSc ; Krishnan, Prabha, MD ; Ng, Woei-Kian, BSN, MSN ; Choudhury, Saugata, MD ; Chan, Joey, MD ; Ang, Brenda, MD, MPH</creator><creatorcontrib>Chow, Angela, MD, MPH ; Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD ; Chan, Siew-Pang, PhD ; Poh, Bee-Fong, BSc ; Krishnan, Prabha, MD ; Ng, Woei-Kian, BSN, MSN ; Choudhury, Saugata, MD ; Chan, Joey, MD ; Ang, Brenda, MD, MPH</creatorcontrib><description>Background The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated. Methods We conducted a randomized controlled trial in the general wards of a 1,300-bed, acute, tertiary care hospital to compare the effectiveness of 3 hand hygiene protocols during routine inpatient care: (1) handrubbing with alcohol covering all hand surfaces, (2) handrubbing with alcohol using the standard 7-step technique, and (3) handwashing with chlorhexidine using the standard 7-step technique. Hand samples were obtained from 60 medical and 60 nursing staff, before and after hand hygiene. Quantitative and qualitative bacterial evaluations were carried out by microbiologists blinded to the protocol. Results All 3 protocols were effective in reducing hand bacterial load ( P < .01). During routine patient care, alcohol handrubbing covering all hand surfaces required less time (median, 26.0 seconds) than alcohol handrubbing using the 7-step technique (median 38.5 seconds; P = .04) and chlorhexidine handwashing (median, 75.5 seconds; P < .001). Conclusion Alcohol handrubbing protocols are as efficacious as chlorhexidine handwashing. Alcohol handrubbing covering all hand surfaces is the most time-effective protocol for routine patient care activities in busy general wards.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2011.10.005</identifier><identifier>PMID: 22325731</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Alcohol handrub ; Alcohols - administration & dosage ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiseptics ; Bacteria - classification ; Bacteria - isolation & purification ; Bacterial Load ; Biological and medical sciences ; Chlorhexidine - administration & dosage ; Disinfectants - administration & dosage ; Effectiveness studies ; Epidemiology. Vaccinations ; General aspects ; Hand - microbiology ; Hand Disinfection - methods ; Hand hygiene ; Health care-associated infection ; Hospitals ; Human infectious diseases. Experimental studies and models ; Humans ; Hygiene ; Infection Control ; Infection Control - methods ; Infectious Disease ; Infectious diseases ; Inpatient care ; Medical sciences ; Nosocomial infections ; Patient care ; Pharmacology. Drug treatments ; Protocol ; Treatment Outcome</subject><ispartof>American journal of infection control, 2012-11, Vol.40 (9), p.800-805</ispartof><rights>Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>2012 Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.</rights><rights>Copyright Mosby-Year Book, Inc. Nov 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c568t-a0638712b45fa5875d14706145831c98926398a3aa59ccd72ab8a4877b40b8d73</citedby><cites>FETCH-LOGICAL-c568t-a0638712b45fa5875d14706145831c98926398a3aa59ccd72ab8a4877b40b8d73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajic.2011.10.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26597605$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22325731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chow, Angela, MD, MPH</creatorcontrib><creatorcontrib>Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD</creatorcontrib><creatorcontrib>Chan, Siew-Pang, PhD</creatorcontrib><creatorcontrib>Poh, Bee-Fong, BSc</creatorcontrib><creatorcontrib>Krishnan, Prabha, MD</creatorcontrib><creatorcontrib>Ng, Woei-Kian, BSN, MSN</creatorcontrib><creatorcontrib>Choudhury, Saugata, MD</creatorcontrib><creatorcontrib>Chan, Joey, MD</creatorcontrib><creatorcontrib>Ang, Brenda, MD, MPH</creatorcontrib><title>Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>Background The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated. Methods We conducted a randomized controlled trial in the general wards of a 1,300-bed, acute, tertiary care hospital to compare the effectiveness of 3 hand hygiene protocols during routine inpatient care: (1) handrubbing with alcohol covering all hand surfaces, (2) handrubbing with alcohol using the standard 7-step technique, and (3) handwashing with chlorhexidine using the standard 7-step technique. Hand samples were obtained from 60 medical and 60 nursing staff, before and after hand hygiene. Quantitative and qualitative bacterial evaluations were carried out by microbiologists blinded to the protocol. Results All 3 protocols were effective in reducing hand bacterial load ( P < .01). During routine patient care, alcohol handrubbing covering all hand surfaces required less time (median, 26.0 seconds) than alcohol handrubbing using the 7-step technique (median 38.5 seconds; P = .04) and chlorhexidine handwashing (median, 75.5 seconds; P < .001). Conclusion Alcohol handrubbing protocols are as efficacious as chlorhexidine handwashing. Alcohol handrubbing covering all hand surfaces is the most time-effective protocol for routine patient care activities in busy general wards.</description><subject>Alcohol handrub</subject><subject>Alcohols - administration & dosage</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiseptics</subject><subject>Bacteria - classification</subject><subject>Bacteria - isolation & purification</subject><subject>Bacterial Load</subject><subject>Biological and medical sciences</subject><subject>Chlorhexidine - administration & dosage</subject><subject>Disinfectants - administration & dosage</subject><subject>Effectiveness studies</subject><subject>Epidemiology. Vaccinations</subject><subject>General aspects</subject><subject>Hand - microbiology</subject><subject>Hand Disinfection - methods</subject><subject>Hand hygiene</subject><subject>Health care-associated infection</subject><subject>Hospitals</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Hygiene</subject><subject>Infection Control</subject><subject>Infection Control - methods</subject><subject>Infectious Disease</subject><subject>Infectious diseases</subject><subject>Inpatient care</subject><subject>Medical sciences</subject><subject>Nosocomial infections</subject><subject>Patient care</subject><subject>Pharmacology. Drug treatments</subject><subject>Protocol</subject><subject>Treatment Outcome</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkstu1DAUhiMEotPCC7BAkRBSNxl8iR0bVUijiptUiQWwthznhPGQxIOdFIbH4Uk5mZm2Uhewsa3zf-f35XeWPaNkSQmVrzZLu_FuyQilWFgSIh5kCypYVXCm5cNsQaiWhRSCn2SnKW0IIZpL8Tg7YYwzUXG6yP6sOhfWocvXdmjiVNd--JbjMnfrLsQ1_PKNH2Cv_rRpPavbGMbgQpfyNsQ8hmncEyFt_Wg7lK0bvYPX-SqP2BZ6_xvQr_ODd6iP0eMY2lufHNoWFbfb7zv6HuYKoMk1DJDSk-xRa7sET4_zWfb13dsvlx-Kq0_vP16urgonpBoLSyRXFWV1KVorVCUaWlZE0lIoTp1WmkmuleXWCu1cUzFbK1uqqqpLUqum4mfZ-cEXD_ZjgjSa3icHXWcHCFMylJdaasVK_X-UMikpU2J2fXEP3YQpDngRpEqtBVGMI8UOlIshpQit2Ubf27gzlJg5bLMxc9hmDnuuYdjY9PxoPdU9NLctN-ki8PII2IRP32Iczqc7Tgpdyb3RxYEDfN5rD9Ek52Fw0PiIOZgm-H-f48299puwv8MO0t19TWKGmM_zt5x_JUVDJnTJ_wI5uN3-</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Chow, Angela, MD, MPH</creator><creator>Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD</creator><creator>Chan, Siew-Pang, PhD</creator><creator>Poh, Bee-Fong, BSc</creator><creator>Krishnan, Prabha, MD</creator><creator>Ng, Woei-Kian, BSN, MSN</creator><creator>Choudhury, Saugata, MD</creator><creator>Chan, Joey, MD</creator><creator>Ang, Brenda, MD, MPH</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Mosby-Year Book, Inc</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><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>20121101</creationdate><title>Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness</title><author>Chow, Angela, MD, MPH ; Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD ; Chan, Siew-Pang, PhD ; Poh, Bee-Fong, BSc ; Krishnan, Prabha, MD ; Ng, Woei-Kian, BSN, MSN ; Choudhury, Saugata, MD ; Chan, Joey, MD ; Ang, Brenda, MD, MPH</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c568t-a0638712b45fa5875d14706145831c98926398a3aa59ccd72ab8a4877b40b8d73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Alcohol handrub</topic><topic>Alcohols - administration & dosage</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiseptics</topic><topic>Bacteria - classification</topic><topic>Bacteria - isolation & purification</topic><topic>Bacterial Load</topic><topic>Biological and medical sciences</topic><topic>Chlorhexidine - administration & dosage</topic><topic>Disinfectants - administration & dosage</topic><topic>Effectiveness studies</topic><topic>Epidemiology. Vaccinations</topic><topic>General aspects</topic><topic>Hand - microbiology</topic><topic>Hand Disinfection - methods</topic><topic>Hand hygiene</topic><topic>Health care-associated infection</topic><topic>Hospitals</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Hygiene</topic><topic>Infection Control</topic><topic>Infection Control - methods</topic><topic>Infectious Disease</topic><topic>Infectious diseases</topic><topic>Inpatient care</topic><topic>Medical sciences</topic><topic>Nosocomial infections</topic><topic>Patient care</topic><topic>Pharmacology. Drug treatments</topic><topic>Protocol</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chow, Angela, MD, MPH</creatorcontrib><creatorcontrib>Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD</creatorcontrib><creatorcontrib>Chan, Siew-Pang, PhD</creatorcontrib><creatorcontrib>Poh, Bee-Fong, BSc</creatorcontrib><creatorcontrib>Krishnan, Prabha, MD</creatorcontrib><creatorcontrib>Ng, Woei-Kian, BSN, MSN</creatorcontrib><creatorcontrib>Choudhury, Saugata, MD</creatorcontrib><creatorcontrib>Chan, Joey, MD</creatorcontrib><creatorcontrib>Ang, Brenda, MD, MPH</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><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chow, Angela, MD, MPH</au><au>Arah, Onyebuchi A., MD, MPH, MS, DSc, PhD</au><au>Chan, Siew-Pang, PhD</au><au>Poh, Bee-Fong, BSc</au><au>Krishnan, Prabha, MD</au><au>Ng, Woei-Kian, BSN, MSN</au><au>Choudhury, Saugata, MD</au><au>Chan, Joey, MD</au><au>Ang, Brenda, MD, MPH</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>40</volume><issue>9</issue><spage>800</spage><epage>805</epage><pages>800-805</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>Background The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend the use of alcohol handrubs to prevent health care-associated infections. However, the efficacy and time effectiveness of different alcohol handrubbing protocols have yet to be evaluated. Methods We conducted a randomized controlled trial in the general wards of a 1,300-bed, acute, tertiary care hospital to compare the effectiveness of 3 hand hygiene protocols during routine inpatient care: (1) handrubbing with alcohol covering all hand surfaces, (2) handrubbing with alcohol using the standard 7-step technique, and (3) handwashing with chlorhexidine using the standard 7-step technique. Hand samples were obtained from 60 medical and 60 nursing staff, before and after hand hygiene. Quantitative and qualitative bacterial evaluations were carried out by microbiologists blinded to the protocol. Results All 3 protocols were effective in reducing hand bacterial load ( P < .01). During routine patient care, alcohol handrubbing covering all hand surfaces required less time (median, 26.0 seconds) than alcohol handrubbing using the 7-step technique (median 38.5 seconds; P = .04) and chlorhexidine handwashing (median, 75.5 seconds; P < .001). Conclusion Alcohol handrubbing protocols are as efficacious as chlorhexidine handwashing. Alcohol handrubbing covering all hand surfaces is the most time-effective protocol for routine patient care activities in busy general wards.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22325731</pmid><doi>10.1016/j.ajic.2011.10.005</doi><tpages>6</tpages></addata></record> |
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| subjects | Alcohol handrub Alcohols - administration & dosage Antibiotics. Antiinfectious agents. Antiparasitic agents Antiseptics Bacteria - classification Bacteria - isolation & purification Bacterial Load Biological and medical sciences Chlorhexidine - administration & dosage Disinfectants - administration & dosage Effectiveness studies Epidemiology. Vaccinations General aspects Hand - microbiology Hand Disinfection - methods Hand hygiene Health care-associated infection Hospitals Human infectious diseases. Experimental studies and models Humans Hygiene Infection Control Infection Control - methods Infectious Disease Infectious diseases Inpatient care Medical sciences Nosocomial infections Patient care Pharmacology. Drug treatments Protocol Treatment Outcome |
| title | Alcohol handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized clinical trial of protocol efficacy and time effectiveness |
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