Effect of Antiseptic Handwashing vs Alcohol Sanitizer on Health Care–Associated Infections in Neonatal Intensive Care Units

Larson, Elaine; Cimiotti, Jeannie P.; Haas, Janet P.; Parides, Michael; Nesin, Mirjana; Della‐Latta, Phyllis; Saiman, Lisa

doi:10.1001/archpedi.159.4.377

Cited by 88 publications

(35 citation statements)

References 56 publications

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“…One effective approach to preventing communicable diseases in congregate settings is the implementation of hand sanitation programs. Implementation of such programs has shown significant reductions in communicable diseases in many congregate settings, including schools (Dyer, Shinder, & Shinder, 2000;Hilburn, Hammond, Fendler, & Groziak, 2003), university campuses (White, Shinder, Shinder, & Dyer, 2001), healthcare facilities (Bischoff, Reynolds, Sessler, Edmond, & Wenzel, 2000;Doebbelin et al, 1992;Eaton, 2005;Hilburn, Hammond, Fendler, & Groziak, 2003;Larson et al, 2005;Park et al, 2010;White, Kolble, Carlson & Lipson, 2003), and military bases (Ryan & Christian 2001;Mott et al, 2007). Little research has been conducted to identify the cognitive stimulants and barriers of using hand sanitizers among military personnel in dining facilities.…”

Section: Statement Of the Problemmentioning

confidence: 99%

“…Studies have also demonstrated the effectiveness of instant hand sanitizers in reducing illness (Doebbeling et al, 1992;Dyer et al, 2000;Guinan, McGuckin, & Ali, 2002;Larson, Cimiotti, Haas, Parides, Nesin, Della, & Saiman, 2005;Lee et al, 2005;White et al, 2001;White et al, 2005). The CDC (2002) has recommended that using alcohol-based hand sanitizers is acceptable if hands are not visibly soiled (Boyce & Pittet, 2002).…”

Section: Guidelines For Hand Hygiene In Health Carementioning

confidence: 99%

“…Studies link hand hygiene to disease and infections in many congregate settings, including elementary schools, college and university campuses, healthcare, and military (Larson et., 2005;Ryan et al, 2001;White, et al, 2001;White, et al, 2005).…”

Section: Application Of Hand Sanitizers In Congregate Settingsmentioning

confidence: 99%

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Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers

Lin

Roberts

2017

American Journal of Infection Control

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Many pathogenic microorganisms are spread by contaminated hands and may lead to foodborne illness. The use of hand sanitizers can significantly reduce bacterial contamination and is an efficient and inexpensive method to prevent infections and sickness. Previous researchers have found that the routine use of hand sanitizers allowed the U.S. Army to significantly reduce illness. However, few studies have been conducted within a U.S. Army dining facility, which is considered to be one of the primary sources of foodborne illness within the U.S. Army. Therefore, using the Theory of Planned Behavior, the purpose of this study was to identify the behavioral intention, attitudes, subjective norms, and perceptions of control of using hand sanitizer among military personnel.The study targeted soldiers using a written survey during their lunch hour on the U.S.Army base at Fort Riley, KS. A total of 201 surveys were collected. All data were screened and entered into IBM SPSS for analysis.Results indicated that attitudes, subjective norms, and perceived behavioral control explained 64% of the variance in behavioral intention. Attitude and subjective norms were found to be significant predictors of behavioral intention, with attitude being the strongest predictor.In general, behavioral beliefs were positive among soldiers. Related to normative beliefs, soldiers did perceive negative social pressure from other soldiers not to use hand sanitizers.Analysis of control beliefs found soldiers perceived hand sanitizers were readily available, but disliked their smell and feel after application.Food production managers and Army commanders can use these results to implement hand sanitation behavioral interventions within military dining environments. Practical implications will likely translate to reduced healthcare costs, decreased absenteeism rates, and improved mission readiness.Some of the limitations include commonly perceived social psychology bias. Further, clustered samples were collected within one military installation in a relatively short amount of time.

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Section: Statement Of the Problemmentioning

confidence: 99%

Section: Guidelines For Hand Hygiene In Health Carementioning

confidence: 99%

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Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers

Lin

Roberts

2017

American Journal of Infection Control

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“…455 In another clinical study in two neonatal intensive care units comparing an alcohol rub with 2% CHGsoap, no difference was found either in infection rates or in microbial counts from nurses' hands. 456 Of note, the ethanol concentration (61%) of the sanitizer was low and the chemicals to neutralize CHG washed from the hands into the sampling fluids might not have been appropriate. However, a randomized clinical trial comparing the efficacy of handrubbing versus conventional handwashing with antiseptic soap showed that the median percentage reduction in bacterial contamination was significantly higher with handrubbing than with hand antisepsis with 4% CHG-soap.…”

Section: Relative Efficacy Of Plain Soap Antiseptic Soaps and Detergmentioning

confidence: 99%

Hand Hygiene

Longtin¹,

Sax²,

Allegranzi³

et al. 2011

N Engl J Med

108

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“…In 5 of these studies, one before and after design with no control group 21 and 4 cohort studies with control groups [22][23][24][25] compared handwashing with the introduction of an alcohol hand sanitizer. Another before and after study with control group 26 compared the 4% antiseptic solution with the introduction of a 1% antiseptic solution.…”

Section: Category 2 Hand Hygiene Productsmentioning

confidence: 99%

An integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care–associated infections

Backman

Zoutman

Marck

2008

American Journal of Infection Control

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Background: The objectives of this integrative review were to critically examine the overall state of the current evidence on the relationship between hand hygiene interventions and the incidence of health care-associated infections (HCAIs) in acute care and long-term care settings, and offer recommendations for future directions in the field based on our findings. Methods: We searched for original research and reviews of research published between January 1, 1996, and July 31, 2006. Studies were identified through the electronic databases Medline, CINAHL, EMBASE, PUBMED, the Cochrane Library, and through expert consultation. Our comprehensive search strategy included all English articles for which hand hygiene or handwashing-related terms were combined with HCAIs. All studies that investigated a relationship between hand hygiene practices and HCAIs in acute care facilities were considered. These hand hygiene practices included the initiation of multimodal hand hygiene initiatives, the introduction of alcohol sanitizers, the implementation or changes of the infection control practices or infection control policies, and other organizational interventions. Studies only examining hand hygiene compliance, efficacy of alcohol hand gels, plain soap, and antimicrobial soap in reducing bacteria count recovered from hands were excluded. Results: Of the 1120 articles retrieved, 35 publications, including 4 reviews of research discussed at the outset of this article, met our inclusion criteria. The remaining 31 eligible original studies included 18 (58.07%) before and after studies without control groups, 4 (12.90%) before and after studies with a control group, 3 (9.68%) cohort studies with no control group, 4 (12.90%) cohort studies with a control group, and 2 (6.45%) randomized trials. Over 50% (16 or 31) of the studies were conducted in the U.S. Two independent reviewers conducted independent evaluations of all eligible studies, critiquing and scoring each study using a rating scale for examining the fatal flaws of quasi-experimental and before and after studies. Conclusions: There is a lack of rigorous evidence linking specific hand hygiene interventions with the prevention of HCAIs. The varied nature of the interventions used and the diverse factors affecting the acquisition of HCAIs make it difficult to show the specific effect of hand hygiene alone. The most frequent methodologies currently used in this research area are before and after observational studies without a control comparison group. Based on these findings, we recommend that researchers used a modified version of Larson's 2005 criteria to guide the design and conduct of future before and after observational studies in this area. We also argue that as we accumulate stronger evidence of which interventions are most effective, we need to develop additional research approaches to study how organizations succeed and fail in fostering the uptake of evidence-based hand hygiene interventions. (Am J Infect Control 2008;36:333-48.)

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Effect of Antiseptic Handwashing vs Alcohol Sanitizer on Health Care–Associated Infections in Neonatal Intensive Care Units

Cited by 88 publications

References 56 publications

Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers

Predicting and explaining behavioral intention and hand sanitizer use among US Army soldiers

Hand Hygiene

An integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care–associated infections

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