QBT1: Task 4 - Revisions
January 28, 2013
Western Governors University
* Alcohol-Based Hand Rubs versus Handwashing Efficacy
* Hand hygiene has been the foundation of preventing nosocomial infections throughout the hospital. It has been taught for several generations that hand hygiene is effectively accomplish through the use of handwashing with soap and water. Unfortunately, studies have shown that handwashing practices have fallen out, which have led to a noticeably low compliance rate with health care workers. This in turn has led to an increase of nosocomial infections, and has had a negative impact on improving the health of patients who rely on physicians, nurses and other ancillary staff who have direct contact with them. Fortunately, an introduction of a new product has been able to change the statistical data with low compliance rate for hand hygiene. Some facilities have introduced the use of alcohol-based hand rubs as an alternative to the conventional handwashing techniques to help decrease the rate of nosocomial infections. There are several factors that indicate a better efficacy rate with using hand rubs versus handwashing. Studies have shown that health care workers have listed barriers and constraints that prevent them from practicing proper hand hygiene; therefore, leading to a low compliance rate. The effect of this low compliance rate leads to longer hospital stays, the development of resistant bacterial infections, and consequently a higher mortality rate among the patients. Research suggests that using alcohol based hand-rubbing solution is more effective in preventing nosocomial infection versus standard hand washing with antiseptic soap because healthcare staff are more compliant with using an alcohol based rubbing solution, consumes less time than standard hand washing practices, and it is readily available throughout the hospitals.
One of the reasons why hand hygiene practices are not preventing nosocomial infections throughout the hospitals is because the healthcare workers are not compliant with the standard handwashing with soap and water. In a study done over a 2-year period in intensive care units (ICUs) Nebraska, Anderson et al. (2007) introduced the use of alcohol-based rubs into one unit, and did not provide alcohol-based rubs into the other unit. The results of the study indicated that the unit, which was given the hand rubs, had a higher compliance rate than that of the other unit, which did not have the hand rub. The participants of the study made modifications to their hand hygiene behaviors because they noted using the alcohol-based hand rubs prevented skin irritation, did not interfere with their time consuming workload, and did not interfere with the normal flora of bacteria on their own hands. The data collected by Anderson et al. (2007) indicated that after the introduction of hand rubs, the compliance rate among the staff increased from 37% to 68%.
Participants from another study also showed an increase in compliance rate while using alcohol-based hand rubs. Brun-Buisson, Girou, Legrand, Loyeau, & Oppein (2002) conducted a study among 23 hospital workers in a three ICUs in a French University Hospital. Every morning during the study, the participants were given an envelope, which randomly assigned them to using either hand rubbing or handwashing as their means for hand hygiene. The objective was to reduce the bacterial colonization with the use of alcohol hand rubs. The results with the efficacy of hand rubs showed 83% reduction of bacteria was achieved versus only 58% efficacy rate with handwashing. With the observations conducted by Brun-Buisson et al. (2002), healthcare workers were more prone for compliance because skin tolerance, and reducing hand contamination was better achieved with alcohol rubs.
Another study examined the increasing compliance rate with healthcare workers...