Reducing MRSA Cross-Contamination In An Acute Surgical Unit: Is There A Place For Alcohol-Based Gel?

Abstract

Background: Cross-contamination is an important source of MRSA infections in surgical patients and is preventable by effective hand decontamination. Although use of alcohol-based alcohol gels improve compliance with hand hygiene amongst health care workers (HCWs) in intensive care units, there is no evidence that they are effective in acute surgical wards. Methods: This was a prospective study in a 57-bed acute surgical unit (general and orthopaedic). Alcohol-based gel dispensers (Spirigel) were attached to each bed for a 12 month period. The installation and annual maintenance costs were estimated. The incidence of MRSA colonization, bacteraemia and significant infection rates were compared in the 12 month periods before and after introduction of Sprigel as well as compliance amongst HCWs. Results: Initial installation of Spirigel and dispensers at each bedside cost £5.07 and annual running costs were estimated at £25.92. MRSA colonization rates were similar before and after introduction of Spirigel. Rates of MRSA bacteraemia and significant infections decreased from 15 to 6.5 per 1000 patients. 48/70 (69%) of HCWs responded to the questionnaire. 46% reported that Spirigel caused an uncomfortable feeling and 23% felt that it was more irritating than handwashing. 73% felt that Spirigel improved compliance with hand hygiene. Overall satisfaction with the product was 75%. Conclusion: Introduction of Spirigel at each patient's bedside in an acute surgical unit improves compliance with hand hygiene amongst health care workers. Preliminary data suggests that this translates into a reduction in MRSA bacteraemia and significant infection rates although longer follow-up is required to confirm this finding.