Alcohol Hand Rub & Hand Hygiene
Efficacy of Hand Hygiene Preparations in Killing Bacteria
The table below demonstrates the efficacy of hand hygiene preparations.
Evidence shows that alcoholbased handrub is better than handwashing with
soap at killing bacteria. Over time alcohol hand rub shows to have better
disinfection than antimicrobial soap and plain soap.
What are the benefits to
using Alcohol Hand Rub?
§
Requires less time
§
Acts faster
§
More effective for standard
handwashing than soap
§
More accessible than sinks
§
Most efficacious agents for
reducing the number of bacteria
on the hands of healthcare
workers
§
Can improve the skins condition
§
Allergic dermatitis found to be
less common side effect of
alcohol based handrubs in
comparison to soap and water
techniques.
Good
Better
Best
Plain Soap
Antimicrobial
soap
Alcoholbased
handrub
Plain soap is good at reducing bacterial
counts but antimicrobial soap is better,
and alcohol based handrubs are best.
Alcoholbased handrubs provide
several advantages compared
with handwashing with soap and
water.
Time After Disinfection
0.0
1.0
2.0
3.0
0
60
180 minutes
0.0
90.0
99.0
99.9
log
%
Bacterial
Reduction
Alcoholbased
handrub
(70% Isopropanol)
Antimicrobial soap
(4% Chlorhexidine)
Plain soap
Baseline
Source:
CDC website
http://www.cdc.gov/handhygiene/download/hand_hygiene_core.ppt#338,12,Slid
e 12 (Adapted from
Hosp Epidemiol Infect Control
, 2
nd
Edition, 1999.)
Dispel the myth: Effect of AlcoholBased Handrubs on Skin Condition
Selfreported studies indicate participants using soap and water reported a
significant increase in dryness, cracking, and irritation after 2 weeks,
whereas those that used the alcoholbased handrub reported significant
improvement in skin condition and dryness.
Epidermal water content shows the same results as the self reported scores,
after 2 weeks of use, the skin water content decreased for those that used
soap and water (resulting in dryer skin) as compared with those who used an
alcoholbased handrub.
Dryne s s of Alcohol Hand Rub
0
1
2
3
4
5
6
Baseline
2 w eeks
A lcohol rub
Soap and w ater
Epiderm al Water Content
15
17
19
21
23
25
27
Baseline
2 w eeks
Alcohol rub
Soap and w ater
Source:
Boyce J,
Infect Control Hosp Epidemiol
2000;21(7):438441
.
Evidence shows that alcoholbased handrubs are less damaging to the skin than soap and water.
The Truth about alcohol based hand rubs
§
Frequent use of alcoholbased formulations for hand antisepsis can cause dry
skin unless emollients and/or skin moisturizers are added to the formula.
§
The drying effect of alcohol can be reduced or eliminated by adding glycerin
and/or other emollients to the formula.
§
In several prospective clinical trials, alcohol based hand sanitizers containing
emollients caused substantially less skin irritation and dryness than soaps or
antimicrobial detergents.
§
Allergic contact dermatitis or contact urticaria syndrome or hypersensitivity to
alcohol or additives present in alcohol hand rubs rarely occurs
Source: Learnwell Resources, available online: www.learnwell.org/handhygiene.htm
Healthy
Dry
Healthy
Dry
It is Important to remember…
§
The efficacy of alcoholbased hand rub is affected by the type of alcohol
used, the alcohol concentration and volume, the contact time and
whether the hands are wet when it is applied.
§
In general, if the hands feel dry after rubbing for 1015 seconds then it is
likely that not enough was applied.
§
Handrubs have been found to be less irritating to the skin than many
soaps although will cause some stinging to areas of broken skin and
abrasions.
Alcoholbased handrubs reduce time needed for hand disinfection
The time required for nurses to
leave a patient’s bedside, go to a
sink, and wash and dry their hands
before attending the next patient is a
deterrent to frequent handwashing
or hand antisepsis.
Easy access to hand hygiene
materials could help improve
adherence.
Alcoholbased handrubs may be a
better option than traditional
handwashing with plain soap and
water or antiseptic handwash
because they require less time, act
faster, and have a lower rate of skin
irritations.
How much time spent cleansing
hands?
One nurse in an average 8 hour shift
Hand washing with soap and
water:
§
56 minutes (based on seven
60 second handwashing
episodes per hour)
Alcoholbased handrub:
§
18 minutes (based on seven
20 second handrub episodes
per hour)
Voss A and Widmer AF,
Infect Control Hosp
Epidemiol
1997:18;205208.
Storage of AlcoholBased Hand Rubs
Alcohols are flammable so it is important to adhere to Occupational Health &
Safety standards when handling and storing alcoholbased handrubs. Be
aware;
§
Containers must be stored and disposed of in a safe manner, and
§
Stored in a cool dry area, away from smoking areas and exposure to
flames.
§
Further information is available from Area Occupational Health and Safety
Coordinators