FEB 25, 2008
A study published in the January Infection Control & Hospital Epidemiology shows that making alcohol-based hand gels common and accessible in hospitals increases their use and cuts the amount of microbes on the hands of nursing staff. But it does not cut the rates of device-associated infections, illness caused by drug-resistant bacteria or cases of Clostridium difficile.
The problem isn't the products. Instead, researchers conclude that their use needs to be carried out in conjunction with other infection control strategies.
Researchers conducted the study in two intensive care units at a medical center over two years. Alcohol-based hand rub and education about its use were provided in one unit the first year and not the other. The second year, the units were reversed. Although the hand hygiene rate nearly doubled in the unit in which the intervention occurred, no change in the hospital-acquired infection rate was detected.
It's possible that the study, which took place in a hospital that already had a low infection rate, was not powered enough to detect a difference and that a longer or larger investigation would find one. Also, although hand hygiene increased to as high as 69 perecent at one point, that rate may not be enough to impact the infectious disease burden.
It's also possible that other strategies that go beyond current recommendations are required. This study, though, found that nurses were more likely to have large amounts of microbes on their hands if they did not have easy access to alcohol hand rub as well as if they wore rings or had nails longer than the finger tip.