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Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

Published online by Cambridge University Press:  30 October 2017

Axel Kramer ,
Didier Pittet ,
Romana Klasinc ,
Stefan Krebs ,
Torsten Koburger ,
Christoph Fusch  and
Ojan Assadian
Axel Kramer
Affiliation:
Institute of Hygiene and Environmental Medicine, University Hospital of Greifswald, Greifswald, Germany
Didier Pittet
Affiliation:
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
Romana Klasinc*
Affiliation:
Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
Stefan Krebs
Affiliation:
Institute of Hygiene and Environmental Medicine, University Hospital of Greifswald, Greifswald, Germany
Torsten Koburger
Affiliation:
Hygiene North GmbH, Greifswald, Greifswald, Germany
Christoph Fusch
Affiliation:
Department of Pediatrics, University Hospital of Greifswald, Greifswald, Germany Center for the Newborn, Children, and Adolescents, General Hospital, Paracelsus Medical School, Nuremberg, Germany
Ojan Assadian
Affiliation:
Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria Institute for Skin Integrity & Infection Prevention, School of Human & Health Sciences, University of Huddersfield, Queensgate, Huddersfield, United Kingdom
*
Address correspondence to Romana Klasinc, MD, Department for Infection Control and Hospital Epidemiology, Medical University of Vienna, General Hospital of Vienna Waehringer Guertel 18-20, 1090 Vienna, Austria ([email protected]).
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Abstract

BACKGROUND

For alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.

METHODS

We conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.

RESULTS

All tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).

CONCLUSION

Time pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.

Infect Control Hosp Epidemiol 2017;38:1430–1434

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 12 , December 2017 , pp. 1430 - 1434
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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