A study of sanitizing hand gels that have become popular with doctors and nurses turned up interesting results. The Nebraska Medical Center’s found alcohol-based hand gels do not offer sufficient protection in killing germs and slowing the spread of hospital acquired infections.
Doctors and nurses will often skip soap and water in favor of hand gel believing that gels work quicker and better on killing bacteria than traditional soap and water; however, hand gels In the Nebraska Medical Center, medical workers nearly doubled their use of the alcohol-based gel but doing so had no impact in decreasing the rate of hospital acquired infections among patients. Dr. Mark Rupp, the doctor who let the study, pointed to a variety of issues, including rings and fingernails that are too long and hard to clean, poor catheter handling, and treatment areas that had not been sanitized. “Hand hygiene is still important, but it’s not a panacea,” said Rupp, an infectious disease specialist at the University of Nebraska Medical Center.
Rupp’s study contradicts the Centers for Disease Control and Prevention (CDC) hospital guidelines that say better hand hygiene—whether by frequent washing or use of sanitizing gels—has been shown to cut the spread of hospital infections, a growing problem in the U.S. The spread of infection-causing germs in U.S. hospitals is responsible for an estimated 1.7 million infections and 99,000 deaths annually, according to the CDC and include drug-resistant staph, urinary tract infections, and ventilator-related pneumonia, among others. “There are many factors that influence the development of hospital-acquired infections. It would be naive to think that a single, simple intervention would fix this problem,” Rupp said. Rupp’s study appears in the January issue of Infection Control and Hospital Epidemiology.
Some research has shown that alcohol-based hand gels are more effective, faster, and easier to use than soap and water. The findings of the new study were based on 300 hours of hand hygiene observations of nurses and doctors in two comparable intensive care units over a two-year period. More gel dispensers were placed in the ICUs; usage rose from 37 percent to 68 percent in one unit and 38 percent to 69 percent in the other. Compliance for hospital hand washing is estimated to be about 40 percent. Every two months, bacteria samples were taken from health workers’ hands, which were found to be cleaner when using gels. Infection rates in both ICUs were relatively low, according to the study and researchers found no significant relationship between hand gel use and infections among patients. In fact, in one unit, the infection rate rose when hand gel was widely available and its use promoted.
Rupp said hospital-borne infections cannot be stopped by better hand hygiene alone since infections are not limited to person-to-person contact and suggests hand gels be combined with other measures, such as better cleaning of hospital units, proper insertion and maintenance of catheters, and antibiotic use only when necessary to help curb the incidence of drug-resistant bacteria and super bugs. Rupp suggested workers not wear rings and trim nails more than CDC recommendations; bacteria are present when the nail only extends just beyond the fingertip.
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