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Comparison of three hand hygiene methods in a surgical intensive care unit



Comparison of three hand hygiene methods in a surgical intensive care unit



Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 41: 425



Background: To improve HH in hospitals, novel methods of hand antisepsis have been designed. Methods: We compared three methods: antimicrobial hand wipe (AW), soap and water (SW), and a 62% ethyl alcohol gel (AL). We evaluated efficacy of these agents when used by registered nurses (RNs) in a 27 bed SICU. We cultured 66 RNs on 282 occasions using a glove juice technique. We randomly sampled a hand; the RN used a randomized HH method, and then we sampled the opposite hand. Selective media were inoculated with resuspended organisms from the filtered glove juice to detect hand contamination by several organism categories: methicillin-resistant coagulase-negative staphylococci (MRCoNS), gram-negative bacilli (GNB), Staphylococcus aureus (SA), Candida species (CS), and vancomycin resistant enterococci. We adjusted for potential risk factors (skin condition, dominant hand, glove use, rings, nail length, nail applications, and number of assigned patients) in multivariate analyses. Results: Contamination by any transient organism (MRCoNS excluded) was 32% before HH, 30% after SW, 28% after AW, and 13% after AL. By multivariate analysis, RN hand contamination was less likely after AL use for each organism category: MRCoNS, OR=.53, p<0.001; GNB, OR=.40, p=0.06; SA, OR=.52, p=0.17; CS, OR=.26, p=0.03; or any of the transient flora, OR=.31, p=0.001. Conclusion: In a clinical setting, AL reduced the frequency of hand contamination by potential pathogens.

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Accession: 034624274

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