Liquid versus gel handrub formulation: a prospective intervention study

Abstract

Introduction Hand hygiene is one of the cornerstones of the prevention of health care-associated infection, but health care worker (HCW) compliance with good practices remains low. Alcohol-based handrub is the new standard for hand hygiene action worldwide and usually requires a system change for its successful introduction in routine care. Product acceptability by HCWs is a crucial step in this process.

Hand Hygiene

“…); 3. capacity to promote improved compliance with hand hygiene by making the process faster and more convenient; 4. economic benefit by reducing annual costs for hand hygiene, representing approximately 1% of extra-costs generated by HCAI (see also Part III, Section 3); 488-490 5. minimization of risks from adverse events because of increased safety associated with better acceptability and tolerance than other products (see also Part I, Section 14). [491][492][493][494][495][496][497][498] For optimal compliance with hand hygiene , handrubs should be readily available, either through dispensers close to the point of care or in small bottles for on-person carriage. 335,485 Health-care settings currently using commercially-available handrubs should continue to use them, provided that they meet recognized standards for microbicidal efficacy (ASTM or EN standards) and are well accepted/tolerated by HCWs (see also Implementation Toolkit available at http://www.who.int/ gpsc/en/).…”

“…Characteristics that can affect HCWs' acceptance of a hand hygiene product include dermal tolerance and skin reactions to the product, and its characteristics such as fragrance, consistency, and colour, 220,493,504,598,610 Structured, self-administered questionnaires may be useful tools to assess HCWs' acceptability of hand hygiene products. A standardized and validated survey to evaluate acceptability and tolerability among HCWs is available within the Implementation Toolkit (http://www.who.…”

“…579 A prospective intervention study and a comparison study have shown that the use of a gel formulation was associated with better skin condition, superior acceptance, and a trend towards improved compliance. 493,496 Nevertheless, it is worth recalling that first generations of gel formulations have reduced antimicrobial efficacy compared with solutions. 205,218 A recent study suggests that the antibacterial efficacy of alcohol-based gels may depend mainly on concentration and type of alcohol in the formulation.…”

“…Several studies suggest that the frequency of hand cleansing is determined by the accessibility of hand hygiene facilities. 335,486,492,493,497,498,[637][638][639] A reliable supplier (industrial or local at the health-care facility) is essential to ensure a continuous supply of products. If industrial products are not available or are too expensive, products may be produced within the local setting (see also Part I, Section 12).…”

Not Perfect-Just Among the Best Available: Reply

“…Recently, a prospective trial in a critical care setting indicated considerably improved hand hygiene compliance when a gel formulation was available, compared with compliance when a liquid formulation was in use. 15 Any increase in potency of the liquid formulation compared with that of the gel might be mitigated by a decrease in hand hygiene compliance.…”