Use Of Alcohol Hand Research Articles

Hand hygiene and hand eczema: A systematic review and meta-analysis.

Hand eczema is a common inflammatory condition of the skin that has been linked to hand hygiene. This systematic review and meta‐analysis aims to determine the risks of hand eczema associated with hand hygiene, including frequency of handwashing, wet‐work and use of alcohol hand rub. A comprehensive search of MEDLINE, EMBASE and Cochrane Library was performed for cohort, case–control or cross‐sectional studies that analysed the association between hand hygiene and risk of hand eczema. Results of individual studies were presented in respective forest plots and pooled summary relative risks were estimated using a random‐effects model. Forty‐five studies were included in analysis. Handwashing at least 8–10 times daily significantly increased risk of hand eczema (relative risk [RR] 1.51; 95% confidence interval [CI]: 1.35–1.68; p < 0.001). The risk was related to handwashing frequency, with higher pooled RR of 1.66 (95% CI: 1.51–1.83; p < 0.001) with increased handwashing at least 15–20 times daily. However, use of alcohol‐based hand sanitizer was not significantly associated with risk of hand eczema. Given the widespread implementation of hand hygiene practices during the COVID‐19 pandemic, there is a pertinent need to understand skin care habits specific to the hands to avoid a greater incidence of hand eczema.

Leveraging ebola viral disease emergency preparedness for infection prevention and control in health care facilities

Background: In August 2018, the Democratic Republic of Congo notified an ebola viral heamorhagice (EVD) outbreak. In response, Uganda strengthened emergency preparedness efforts in preparation for any spillover of the outbreak, particularly in the Albertine, South Western region, Rwenzori and West Nile. In particular, infection prevention and control (IPC) interventions were strengthened in addition to other key interventions. We evaluated the response towards IPC during the EVD preparedness. Methods and materials: We conducted a desk review of the meeting proceedings for the EVD preparedness and response efforts by the National Task Force. We specifically looked at the efforts that were put in place concerning IPC. Results: At the beginning of the outbreak there was lack of sanitation facilities in places like the screening points, including lack of reliable and quality water supply. Waste segregation was not appropriate and there were no hand washing facilities at in most health facilities as well as lack of IPC guidelines. In response, the following interventions were put in place; (i) Mentoring of health workers on chlorine preparation and hand hygiene. (ii) Assessment of IPC in health facilities were carried out in order to guide the action plan. These assessments were regularly conducted depending on the situation and these included, both internal and external evaluation of the progress. The IPC assessments also included evaluation for hand washing on the different units of the health facilities. (iii) There are also CMEs on IPC including waste management and including distribution of information education materials. (iv) IPC committees in health facilities and at the district were constituted or revived. Gate keepers were utilized to foster hand washing by having the hand washing facilities at the gates, to ensure that every one coming in the facility washes their hands. Conclusion: Emergence preparedness strengthened the IPC in the affected health facilities, particularly the promotion of hand washing facilities and promoted the use of alcohol hand rub. This could potentially improve hand hygiene in health care facilities-including community members. Capacity built should be maintained for overall healthcare safety.

How do healthcare workers in diagnostic imaging minimise risks but maximise performance during the COVID-19 pandemic?

How do healthcare workers in diagnostic imaging minimise risks but maximise performance during the COVID-19 pandemic?

Conservation of Water During Handwashing

Wastage of water during handwashing is an issue that has received insufficient attention. The problem results from the need to avoid re-contamination of hands during hand washing, and has been addressed by using running water, and not touching the tap to turn off the flow of water during the procedure. This video of a standard non-surgical scrub provides a clear illustration of the problem with 75% of the water being wasted. The volume of water used in handwashing is determined by its duration, the rate of water flow, and how often the procedure is performed. Conservation of water during handwashing can be achieved by the use of various devices to turn off the tap when water is not required. Other methods of water conservation are avoidance of excessively long handwashing, usage of a moderate water flow rate, and the appropriate use of alcohol hand rub. It is hoped that this reminder will help encourage health care workers to conserve water.

Transmission of metallo-β-lactamase-producing Pseudomonas aeruginosa in a nephrology-transplant intensive care unit with potential link to the environment

Pseudomonas aeruginosa has been recovered in hospitals from many different sources including sinks and taps. Because P. aeruginosa is one of the main agents of nosocomial infections and increasingly resistant to antibiotics, environmental reservoirs in hospital settings are of great concern. We report here on a cluster of five cases of infection by P. aeruginosa expressing VIM carbapenemases (VIM-PA) in a nephrology intensive care unit. Our investigation pointed to transmission of VIM-PA via hands related to a contaminated tap. VIM-PA may be cross-transmitted to other patients if an environmental reservoir exists. Sinks and taps should be well designed and thoroughly cleaned and disinfected, and use of alcohol hand rub should be promoted.

Hand hygiene in reducing transient flora on the hands of healthcare workers: an educational intervention.

Hand hygiene has now been recognised as one of the most effective intervention to control the transmission of infections in a hospital and education is an important tool to ensure its implementation. In order to convince the users and as a part of education, it is important to generate evidence on the role of hand hygiene in reducing the bacterial flora on their hands. The present study was undertaken in a tertiary care hospital to demonstrate the presence of bacterial flora on the hands of healthcare workers (HCW) in different categories, to teach them proper hand hygiene technique using alcohol-based hand rub and determine the outcome for reduction of bacteria. A total sample size of 60 subjects including resident doctors, medical students, nurses and hospital attendants were included in the study after obtaining informed consent. Each person was educated on the technique of hand hygiene with alcohol-based hand rub and hand impressions were cultured before and after hand hygiene. All the subjects were also given a questionnaire to assess their perception on hand hygiene. The WHO posters on proper hand hygiene were displayed in the appropriate areas of the hospital in addition, as an educational tool. Majority (42 out of 60) of the HCWs had bacterial count up to 100 colonies or more on both hands before the application of hand rub while working in the hospital. After use of alcohol hand rub with a proper hand hygiene technique, it was found that the percentage reduction was 95-99% among doctors and nurses, 70% among hospital attendants and 50% among sanitary attendants. Staphylococcus aureus was present on the hands of eight persons of which three were methicillin-resistant Staphylococcus aureus. The study demonstrates that transient bacteria are present on the hands of HCWs but majority could be removed by proper hand hygiene, which needs continuous education to be effective. It also shows that active education by demonstrating the proper hand hygiene technique and direct observation of the practices, though demanding, are ideal to understand the attitudes and practices of HCWs and helps in planning implementation strategies.

Cultural determinants of infection control behaviour: understanding drivers and implementing effective change

Despite dealing with biomedical practices, infection prevention and control (IPC) is essentially a behavioural science. Human behaviour is influenced by various factors, including culture. Hofstede's model of cultural dimensions proposes that national cultures vary along consistent dimensions which can be grouped and scored as specific constructs. Studies have reported that three Hofstede constructs--power distance, uncertainty avoidance, and masculinity--show significant association with several key performance indicators relevant to IPC and antibiotic stewardship. In addition, national meticillin-resistant Staphylococcus aureus (MRSA) levels within Europe correlate well with general quality-of-care indices, including preventive strategies and patient rights. This suggests that IPC may be simply a microcosm of overall quality and safety standards within hospitals and countries. Effective improvement would therefore need to address underlying and embedded core cultural values relevant to patient safety and quality of care. Successful IPC strategies are likely to be those that are compatible with the cultural background where they are implemented. To this end, content analysis of many current IPC improvement tools identifies elements of strong compatibility with cultures that are low in uncertainty avoidance and power distance, and high in individualism and masculinity. However, this cultural combination is largely restricted to Anglo-Saxon countries, where most of the recent improvements in healthcare-associated infection (HCAI) incidence have taken place. There is a paucity of research on IPC behaviour change in different cultural backgrounds, especially countries that score high for power distance and/or uncertainty avoidance. This information is vital to inform IPC campaigns in these countries, which often show high HCAI prevalence.

P111: It is not in your hands!

Hand hygiene (HH) is well-recognised as part of best practice in preventing cross infection. In light of the P.aeruginosa outbreak in neonatal units in the UK, it is recommended that healthcare workers (HCWs) should routinely use alcohol hand rub after hand washing in all augmented care areas. Since this practice may lead to dermatitis, we have conducted this study to assess whether use of alcohol hand rub was necessary after hand washing (HW) as we were unable to find any scientific papers to support this recommendation.

P14.17 Does systematic feedback on use of alcohol hand rub and soap affect healthcare-associated infections in hospitals? A controlled intervention study

P14.17 Does systematic feedback on use of alcohol hand rub and soap affect healthcare-associated infections in hospitals? A controlled intervention study

Use of alcohol hand rub (AHR) at ward entrances and use of soap and AHR by patients and visitors: a study in 27 wards in nine acute NHS trusts

Ward procurement of hand hygiene consumables is a proxy measure of hand hygiene compliance. The proportion of this due to use of alcohol hand rub (AHR) at ward entrances, and bedside use of consumables by patients and visitors, is unknown. Thirty-six hours of direct observation of bedside hand hygiene behaviours by healthcare workers (HCWs), patients and visitors on 27 wards in nine hospitals was undertaken. AHR containers from ten ward entrances were collected for four days. Mean daily volume used was compared with mean daily volume procured. Only 4% of bedside soap and AHR use was by visitors. Patients used neither. An average 21% (range 7—38%) of all AHR procured by wards was used at ward entrances. Non-HCW use of soap or AHR at the bedside is low. Ward entrance use of AHR is modest but varies. Hand hygiene intervention studies using consumables as an outcome should assess and adjust for such usage.

An uncommon problem associated with alcohol excess: flexor sheath infection following use of alcohol hand rub

An uncommon problem associated with alcohol excess: flexor sheath infection following use of alcohol hand rub

When are the hands of healthcare workers positive for meticillin-resistant Staphylococcus aureus?

Hand hygiene is a key component in reducing infection. There are few reports on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) on healthcare workers' (HCWs') hands. The aim of this study was to establish whether HCWs' fingertips were contaminated with MRSA in a clinical hospital setting. The study was conducted in an acute tertiary referral hospital on four MRSA wards that were part of a larger research study on MRSA epidemiology and four other wards not included in the study. The fingertips from all categories of 523 HCWs were sampled on 822 occasions by the imprinting of fingertips on MRSA chromogenic agar plates. The type of hand hygiene agent used, if any, and the immediate prior activity of the HCW were recorded. Overall, 38/822 (5%) fingertips from 523 HCWs were MRSA-positive; 12/194 (6%) after clinical contact, 10/138 (10%) after contact with the patient's environment and 15/346 (4%) after no specific contact. MRSA was recovered on 2/61 (3%) occasions after use of alcohol hand rub, 2/35 (6%) after 4% chlorhexidine detergent, 7/210 (3%) hand washing with soap and water, and 27/493 (5%) when no hand hygiene had been performed. MRSA was recovered from HCWs on seven of the eight wards. MRSA was more frequently present on fingertips on the four non-study wards vs the four MRSA study wards [18/250 (7%), 3/201 (1%), respectively; P<or=0.004]. The isolation of MRSA from HCWs' fingertips, including after hand hygiene, indicates that more educational programmes are necessary to improve the quality of hand hygiene to prevent transmission of MRSA.

Outbreak of human metapneumovirus infection in psychiatric inpatients: implications for directly observed use of alcohol hand rub in prevention of nosocomial outbreaks

Nosocomial outbreaks of infectious diseases in psychiatric facilities are not uncommon but the implementation of infection control measures is often difficult. Here, we report an outbreak of an acute respiratory illness in a psychiatric ward between 29 July and 20 August 2005 involving 31 patients. Human metapneumovirus was detected in seven (23%) patients by reverse transcription-polymerase chain reaction and nucleotide sequencing. A review of outbreak surveillance records showed that six nosocomial outbreaks occurred in the year 2005, of which four (67%) were confirmed or presumably related to a respiratory viral infection. Directly observed deliveries of alcohol hand rub 4-hourly during daytime to all psychiatric patients was instituted in December 2005. Only one nosocomial respiratory viral outbreak occurred in the following year. The total number of patients and staff involved in nosocomial outbreaks due to presumed or proven respiratory virus infections decreased significantly from 60 to six (P<0.001), whereas those due to all types of nosocomial outbreaks also decreased from 70 to 24 (P=0.004). Alcohol hand rub has been shown to have potent bactericidal and virucidal activity against a wide range of nosocomial pathogens. Regular use of directly observed alcohol hand rub may decrease the incidence and scale of nosocomial outbreaks due to enveloped respiratory viruses especially in mentally incapacitated patients.

Effect of Education on Hand Hygiene Beliefs and Practices A 5-Year Program

To evaluate infection control and hand hygiene understanding at 3 public hospitals, we surveyed 4,345 healthcare workers (HCWs) 3 times during a 5-year infection control intervention. The preference for the use of alcohol hand rub for hand hygiene increased dramatically; in nurses, it increased from 14% to 34%; in physicians, 4.3% to 51%; and in allied HCWs, 12% to 44%. Study year, infection control interactive education-session attendance, infection control knowledge, and being a physician or allied HCW independently predicted a preference for alcohol hand rub.

Combined use of alcohol hand rub and gloves reduces the incidence of late onset infection in very low birthweight infants

Objective: To assess the incidence of late onset (> 72 hours) infection and necrotising enterocolitis (NEC) in very low birthweight (VLBW) infants in two 36 month periods using two hand...