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PubMed1990

[Prevention of adenovirus infection and antiviral activity of a hand disinfectant, Welpas].

A commercial alcoholic disinfectant (Welpas) was tested for its activity against adenovirus type 3 (Ad 3) by using two procedures, the in vitro suspension test and the in vivo fingertip test. Other available techniques for the sterilization of fingers were also evaluated for removal of Ad by using the fingertip test. In the suspension tests, the infectivity of Ad 3 was reduced to undetectable levels within 30-60 seconds. This results suggest the effectiveness of this disinfectant in reducing Ad infectivity. In the fingertip tests, the viruses were recovered from fingertips in varying titers after using one of the following techniques: wiping with tissue papers, washing with running water, washing with soap and rinsing with water, rubbing with Welpas, wiping with cotton soaked in 70% alcohol, or washing with a brush under running water. However, the viruses were not recovered when the fingertip was washed with water, wiped with paper, and rubbed with Welpas successively. This technique was found to be the most effective method currently available.

Adenoviridae Infections↗
PubMed2000

Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit.

We investigated whether rubbing with an alcohol solution increases compliance with hand disinfection in a medical intensive care unit (MICU). During a first period (P1), hand disinfection was achieved only through conventional washing, whereas during a second period (P2), hand disinfection could be achieved either through conventional washing or rubbing with an alcohol solution. There were 621 opportunities for hand disinfection during P1 and 905 opportunities during P2. General compliance during P1 was 42.4%, and reached 60.9% during P2 (p < 0.001). This improvement was observed among nurses (45.3% versus 66.9%, p < 0.001), senior physicians (37. 2% versus 55.5%, p < 0.001), and residents (46.9% versus 59.1%, p = 0.03). Acceptability and tolerance were evaluated through the answers to an anonymous questionnaire distributed to all 53 health care workers in the MICU. Rubbing with alcohol solution was an easy procedure (100% of responses) and induced mild side effects in less than 10% of respondents. In a complementary study conducted 3 mo after the first one, compliance remained better than during P1 (51. 3% versus 42.4%, p = 0.007). These findings suggest that rubbing with alcohol solution increases compliance with hand disinfection, and that it could be proposed as an alternative to conventional handwashing in the MICU.

Attitude of Health Personnel↗
PubMed2004

Efficacy of alcohol-based gels compared with simple hand wash and hygienic hand disinfection.

A recent research letter on the limited efficacy of alcohol-based hand gels has alerted the global infection control community and raised the question of the true significance of data obtained according to EN 1500. It has been described that a 1 min simple hand wash reduces artificial contamination of hands by a log(10) reduction factor of 2.8 and a 1 min reference hand disinfection with 2-propanol (60%, v/v) by a factor of 4.6 steps. The EN 1500 gel data show that the 30 s efficacy of most gels is closer to a simple hand wash than to the reference hand disinfection. The 30 s efficacy of most alcohol-based liquid products and one gel, however, is almost identical to the reference hand disinfection. In many European countries alcohol-based liquid products have been established as a standard practice in hygienic hand disinfection for decades. Replacement of these products with most available gels would be a step backward in terms of efficacy and has still to be seen critically from the efficacy point of view.

Anti-Infective Agents, Local↗
PubMed2005

Less skin irritation from alcohol-based disinfectant than from detergent used for hand disinfection.

BACKGROUND: The benefit of alcohol-based disinfectant used on normal skin has been debated. OBJECTIVES: The objective of the present study was to compare the effects of repeated exposure to an alcohol-based disinfectant, a detergent and an alcohol-based disinfectant/detergent alternately for 10 days, including noninvasive measurements in the evaluation. Skin reactivity in irritated skin after a 4-week interval was also evaluated. MATERIALS AND METHODS: Detergent, disinfectant and alternate disinfectant and detergent were applied twice daily every 10 min for 1 h to the ventral upper arms and forearms of 17 healthy volunteers. A control area was included. After 4 weeks an SLS patch was applied to each area. Irritant reactions were quantified with a visual score recording and measurements of transepidermal water loss (TEWL) and skin colour were performed on days 1, 5, 11, 38 and 40. RESULTS: On day 5 the detergent caused a higher visual score than either disinfectant applied alone or alternate disinfectant and detergent, P < 0.05. On day 11 detergent and alternate disinfectant and detergent caused a higher score than disinfectant, P < 0.05. An increased irritant response for detergent compared with disinfectant alone and alternate disinfectant and detergent was confirmed by TEWL evaluations on days 5 and 11, P < 0.001, while no significant difference was found by colour measurement. After 4 weeks, when evaluated by colour measurement, significantly less response to the SLS patch was found on the disinfectant-treated area compared with the control area and detergent area, and a similar trend was found for TEWL, although it was not statistically significant. CONCLUSION: Alcohol-based disinfectant caused less visible skin irritation and less skin barrier disruption than the use of detergent. The alternate use of detergent and disinfectant caused less irritation than the use of detergent, and a possible interaction between the two irritants was not indicated. After 4 weeks there was a tendency for decreased skin reactivity in the skin areas which had 4 weeks previously been exposed to disinfectant.

Adult↗
PubMed2003

Dermatological aspects of a successful introduction and continuation of alcohol-based hand rubs for hygienic hand disinfection.

With the new Centers for Disease Control and Prevention (CDC) guideline on hand hygiene, hospitals often introduce alcohol-based hand rubs for hand disinfection. Healthcare workers, however, may reject the new products because of skin irritation or other skin-related problems, which they experience after years of handwashing. In order to facilitate a successful introduction and continued use of alcohol-based hand rubs in hospitals, we have reviewed and summarized the major studies on the topic. Occupational hand dermatitis may occur in up to 30% of healthcare workers. It is mainly described as an irritant contact dermatitis caused by detergents. The diagnosis is usually clinical. Allergic reactions are very rare. After using an alcohol-based hand rub for the first time, healthcare workers may have a burning skin sensation that can be explained by pre-irritated skin. In this case the skin barrier has usually been impaired by frequent handwashing or occlusive gloves. This may result in a vicious circle whereby the healthcare worker increases the frequency of handwashing and reduces the frequency of hand disinfection. Prevention of irritant contact dermatitis is possible by selection of a low-irritating hand rub, which contains emollients, the correct use of the hand rub and a clear guideline when to disinfect and wash hands in the clinical setting. Common mistakes in the use of alcohol-based hand rubs are application to pre-irritated skin and washing hands before hand disinfection, which is, in general, not necessary, or after hand disinfection, which results in washing off the emollients. Clear preparation and guidance of healthcare workers before the introduction of alcohol-based hand rubs can help to enhance compliance in hand hygiene. The switch from handwash to alcohol-based hand rub will improve healthcare workers skin if mistakes are avoided and hand rinses are used correctly.

Alcohols↗
PubMed2006

Effect of a 1 min hand wash on the bactericidal efficacy of consecutive surgical hand disinfection with standard alcohols and on skin hydration.

BACKGROUND: In most surgical theatres, a 1 min or even longer hand wash is routine as part of the pre-operative hand disinfection. But its benefit has recently been seen critically. METHODS: We have therefore investigated the effect of a 1 min hand wash on skin hydration and on the efficacy of consecutive surgical hand rubbing with three standard alcohols (60% propan-1-ol, 60% propan-2-ol, 80% ethanol; all v/v) on the resident hand flora. Three types of treatment were performed: (i) a 1 min pre-wash before surgical hand disinfection, (ii) no pre-wash before surgical hand disinfection and (iii) no pre-wash but use of a brush for 1 min during disinfection procedure. The efficacy of the alcohols was determined according to prEN 12791 with the same 20 volunteers in paired groups. To assess the effect of the hand wash on skin hydration, 10 volunteers washed their hands with sapo kalinus for 1 min and dried hands with a paper towel. Skin hydration was measured with a corneometer before the hand wash and subsequently up to 10 min thereafter both on the palm and dorsum of hands. We also tested the reduction of bacterial spores by a 15 s hand wash according to EN 1499 after artificial contamination of hands of 14 volunteers with spores of B. stearothermophilus. RESULTS: Propan-1-ol (60%) was most effective with a mean log10 reduction of 2.11, followed by ethanol (80%) with a mean log10 reduction of 1.76 and propan-2-ol (60%) with a mean log10 reduction of 0.57 (all immediate effect without hand wash). The efficacy of the alcohols was neither significantly improved nor impaired by a preceding 1 min hand wash, but there is a trend towards better efficacy on dry hands. Using a brush for 1 min during disinfection resulted in a better efficacy with all alcohols. An anaylsis of variance revealed that the immediate effect of ethanol (p = 0.013) and propan-2-ol (p = 0.001) is significantly influenced by the variation of treatments which is mainly explained by the effect of brushing during disinfection. But no significant difference between treatment variations was found in the sustained effect with any of the alcohols. Skin hydration increased significantly by a 1 min hand wash for up to 10 min despite drying hands with a paper towel. A 15 s hand wash reduced the number of bacterial spores significantly from log10 3.84 to log10 1.99 (p = 0.001). CONCLUSIONS: There is no benefit of a hand wash as part of surgical hand disinfection except that a short hand wash of 15 s can effectively reduce spores. The best time for this short hand wash is at the beginning of work in hospital, but at the latest in the sluice of the operating theatre about 10 min before applying an alcohol-based hand rub to give the skin enough time to dry.

Adult↗
PubMed2002

Impact of teaching interventions on nurse compliance with hand disinfection.

The impact of teaching interventions and the availability of additional dispensers for alcoholic hand disinfection was measured during three study periods. A nursing care system of relevant nursing interventions was found to be a useful tool for the assessment of compliance with hand hygiene requirements if combined with an analysis of hand disinfectant use. This study shows that compliance with hand disinfection can be improved through targeted teaching and supportive structural improvements, and that this positive impact may persist even after targeted teaching activities have ended.

Guideline Adherence↗