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PubMed1990

Hygienic hand disinfection tests in three laboratories.

A comparative study was made in three laboratories of a test for hygienic hand disinfection. Staphylococcus aureus was applied to the fingertips of a total of 74 volunteers (49 female and 25 male) and the effect of washing with three chlorhexidine preparations and one non-medicated soap was assessed after one and five applications. Fingertip inoculation is convenient and is a realistic representation of the in-use situation. Although significant differences were obtained between log10 reductions in test organisms using the same formulation in different centres, and different periods in the same centre, the maximum differences after a single application of a preparation were small, e.g. between centres 0.39 and between periods in the same centre 0.55, and after multiple applications the maximum difference between centres was 0.42 and between periods in the same centre it was 0.51. The differences between preparations were similar in all centres. This test compares well with other similar tests and products can be placed in rank order of effectiveness. It is concluded that this test, if carried out under the controlled conditions described, is sufficiently reproducible between laboratories and repeatable within laboratories to be used as a standard test.

Chlorhexidine↗
PubMed2003

Preference and compliance of waterless hand-hygiene products versus soap and water.

PURPOSE: To compare handwashing using traditional antimicrobial soap and water with two antimicrobial waterless hand-hygiene products for personal preference and compliance. METHODS: Fifty dental and dental hygiene students were randomly chosen to participate in the study. All subjects were anonymously observed prior to the introduction of the waterless products for handwashing compliance using soap and water for 1 week. All subjects were then instructed on the use of a waterless gel and foam for handwashing. Both waterless products were used for a period of 1 week and students again were anonymously observed. A questionnaire was distributed at the conclusion of the study to determine product preference. RESULTS: During handwashing with soap and water, the average time the soap was in contact with the hands was 7.0 seconds. The average contact time with the gel and foam was 15.3 seconds and 20.0 seconds, respectfully. Questionnaire results indicated that the foam was significantly preferred over the gel and soap and water (54%, 28% and 16%, respectively). The foam was also significantly preferred when evaluating fragrance (52%), kindness to the skin (66%), convenience (64%) and fastest drying time (54%). Results from this study indicate that the waterless foam product was significantly preferred over the waterless gel and traditional soap and water for handwashing procedures. Since handwashing guidelines, regardless of which product used, recommend a minimum of 15 seconds to minimize the number of transient microorganisms on the hands, compliance was found only with the foam and the gel.

Anti-Infective Agents, Local↗
PubMed2006

Study of hand hygiene and enteroparasite infestation among food handlers working in a medical college of North India.

The present study was conducted to assess: 1) Prevalence of enteroparasite infestation among food handlers working in food service establishments located in the campus of a medical college, 2) Presence of enteric organisms on their hands and nails and their hand washing practices. A total of 151 food handlers were interviewed regarding their socio-demographic and professional characteristics. Their hand washing practices were also observed. Stool examination for enteroparasites and stool culture for Salmonella & Shigella and culture of nail clippings / nail bed swabs for detecting presence of enteric organisms were also carried out. Prevalence of enteroparasite infestation was observed to be 41.1%. None of the stool samples was observed to be positive for Salmonella or Shigella. Enteric organisms were isolated from nail clippings/nail bed swab samples of 76 (73.1%) study subjects. Hand washing practices were observed to be poor with low use of soap. Findings highlight importance of periodic stool examination and deworming of food handlers and need to educate them about importance of maintaining hand hygiene with a focus on improving their hand washing practices.

Adult↗
PubMed2004

Differences in hand hygiene behavior related to the contamination risk of healthcare activities in different groups of healthcare workers.

BACKGROUND: The Fulkerson scale lists 15 typical clinical activities ranked according to their risk of hand contamination. OBJECTIVE: To investigate how often healthcare workers (HCWs) apply antiseptic handrubs after each of the specified activities ranked in the Fulkerson scale. DESIGN: Observational study. SETTING: University Hospital of Heidelberg, a 1,600-bed teaching hospital. METHODS: Using a structured protocol, 41 observers recorded whether HCWs rubbed their hands in 1 of 15 given situations. RESULTS: Handrubs were used in 1,115 (52.2%) of 2,138 observations. Comparatively high rates of handrub use were observed after contact with sterile materials (39.6%) and after contact with excretions (90% to 97%). Nurses used handrubs significantly more frequently than did physicians after contact with the inanimate environment, but physicians applied handrubs significantly more frequently after contact with body secretions. CONCLUSIONS: This study showed better compliance with hand hygiene than that reported by many previous studies, but compliance was still inadequate and varied significantly by type of HCW, type of activity, and location in the hospital.

Alcohols↗
PubMed1999

[Hand-hygiene and sickness among small children attending day care centers. An intervention study].

The purpose of the study was to evaluate the effect of intensified hygiene with frequent handwashing and several educational procedures in day-care centres. The study was conducted as a controlled trial, with an intervention group and an observation group. There was a 34% reduction in expected sickness in children in the intervention group. In the categories diarrhoea and eye-infection there was a significant drop in sickness. We conclude that broad intervention concerning hand-hygiene has a positive effect on sickness in children attending day-care centres.

Bacterial Infections↗
PubMedDate not supplied

The evolution: Handwashing to hand hygiene guidance.

Handwashing is a fundamental principle and practice in the prevention, control, and reduction of healthcare-acquired infection. Advocated by Semmelweiss (Nursing, The Finest Art: An Illustrated History. St Louis: Mosby; 1985:204) from the 1800s to resolve an obstetric morbidity and mortality occurrence, the simple act of hand cleansing portrays the intuitive benefits to basic hygiene, health continuum, and, most important, disease prevention. According to recently published guidance (MMWR Morb Mortal Wkly Rep. October 25, 2002;51:32-34), the term handwashing is replaced by the new term hand hygiene, which includes hand cleansing, hand disinfecting, and surgical hand scrub. This article focuses on the published guidance, blending the salient aspects of hand hygiene practices from noted champions, reinforcing the aesthetics of meticulous cleansing, to guidance on its practice in healthcare settings. In healthcare, the principle of "clean hands are healing hands" bears value and demands compliance in order to prevent and control infectious processes while protecting the person from acquiring infectious diseases.

Antisepsis↗
PubMed1965

HAND HYGIENE.

Explore the source record for details and available documents.

Bacteria↗
PubMed2006

The influence of nurse cohorting on hand hygiene effectiveness.

BACKGROUND: Direct contact between health care staff and patients is generally considered to be the primary route by which most exogenously-acquired infections spread within and between wards. Handwashing is therefore perceived to be the single most important infection control measure that can be adopted, with the continuing high infection rates generally attributed to poor hand hygiene compliance. METHODS: Through the use of simple mathematical models, this paper demonstrates that under conditions of high patient occupancy or understaffing, handwashing alone is unlikely to prevent the transmission of infection. CONCLUSIONS: The study demonstrates that applying strict nurse cohorting in combination with good hygiene practice is likely to be a more effective method of reducing transmission of infection in hospitals.

Attitude of Health Personnel↗
PubMed2004

Hand hygiene.

Explore the source record for details and available documents.

Hand Disinfection↗
PubMed2004

A tool to assess barriers to adherence to hand hygiene guideline.

This Brief Report presents results of preliminary testing of a tool, "Attitudes Regarding Practice Guidelines," adapted from previous work by Cabana et al to examine barriers to adherence to practice guidelines. In a small sample of 21 clinicians (10 infectious disease physicians and 11 clinical nurses), the test-retest reliability was.86 and Chronbach alpha was.80, indicating acceptable levels of stability. It is recommended that the instrument undergo further testing and adaptation as a measure of potential barriers to adherence to practice guidelines in general, and to the new Hand Hygiene Guideline for Healthcare Settings specifically.

Attitude of Health Personnel↗
PubMed1992

A multicenter questionnaire investigation of attitudes toward hand hygiene, assessed by the staff in fifteen hospitals in Denmark and Norway.

A questionnaire survey was carried out anonymously among 2557 health care workers in Denmark and Norway to identify and quantify factors that affect the handwashing behavior of physicians, nurses, and other staff groups who perform direct patient care. For number of daily patient contacts physicians reported significantly fewer instances of hand hygiene (HH) per day than did those in other medical professions. Male physicians reported significantly fewer HH per day than did their female colleagues. Significant differences were found among staff groups in emphasis on factors motivating and discouraging HH. The main motivating factor for all groups, however, was an awareness that HH is important for the prevention of infection. Skin problems from frequent handwashing and the use of agents that irritate and dry the skin were the main reasons for disinclination toward HH. The number of points given to these statements correlated well with the stated frequency of HH in staff groups with relatively many (9 to 24) patient contacts per day. Many studies have revealed low standards of HH in health care settings. Whenever HH is taught, the significance of HH for the prevention of infection is always stressed. The participants in this survey were well aware of this significance, but there is still a discrepancy between theory and practice. Goal-specific strategies to improve HH practices would probably be more effective if more were done to minimize the factors that health care workers find detrimental to HH. Continual evaluation of the possibly detrimental effects of current hand washing agents should also be carried out.

Attitude of Health Personnel↗
PubMed1991

Hygienic hand disinfection for the removal of epidemic vancomycin-resistant Enterococcus faecium and gentamicin-resistant Enterobacter cloacae.

An outbreak strain of Enterococcus faecium, bearing plasmid-mediated vancomycin resistance, and an epidemic gentamicin-resistant, multiply-resistant strain of Enterobacter cloacae, both survived well on fingertips of three volunteers for up to 30 minutes after inoculation. Hand disinfection of inoculated fingers with 60% isopropyl alcohol, or with alcoholic chlorhexidine, reliably gave a 4 log10 reduction of both test organisms. Enterobacter cloacae could not be detected in any finger washings, even by enrichment culture. Chlorhexidine digluconate and povidone-iodine were also effective against E. faecium and Ent. cloacae, giving 4 log10 reductions, but finger washings taken after disinfection yielded low counts of the test strains, e.g. less than 45 recoverable colony forming units (cfu) per finger. Handwashing with soap and water was the least reliable method. The epidemicity, serious antimicrobial multiple resistance and survival on finger-tips of these two strains justifies the use of handwashing agents which have maximum effect. The rapid bactericidal (and residual) activity of alcoholic chlorhexidine suggests that, on the basis of present evidence, it is the preferred agent for hygienic hand disinfection against such strains.

Adult↗