Nursing preference for alcohol-based hand rub volume

Abstract

Background:The effectiveness of alcohol-based hand rub (ABHR) is correlated with drying time, which depends on the volume applied. Evidence suggests that there is considerable variation in the amount of ABHR used by healthcare providers.Objective:We sought to identify the volume of ABHR preferred for use by nurses.Methods:A prospective observation study was performed in 8 units at a tertiary-care hospital. Nurses were provided pocket-sized ABHR bottles with caps to record each bottle opening. Nurses were instructed to use the volume of ABHR they felt was best. The average ABHR volume used per hand hygiene event was calculated using cap data and changes in bottle mass.Results:In total, 53 nurses participated and 140 nurse shifts were analyzed. The average ABHR dose was 1.09 mL. This value was greater for non-ICU nurses (1.18 mL) than ICU nurses (0.96 mL), but this difference was not significant. We detected no significant association between hand surface area and preferred average dose volume. The ABHR dose volume was 0.006 mL less per use as the number of applications per shift increased (P = .007).Conclusions:The average dose of ABHR used was similar to the dose provided by the hospital’s automated dispensers, which deliver 1.1 mL per dose. The volume of ABHR dose was inversely correlated with the number of applications of ABHR per shift and was not correlated with hand size. Further research to understand differences and drivers of ABHR volume preferences and whether automated ABHR dosing may create a risk for people with larger hands is warranted.

Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare

“…One possible solution to increase volume and application time in clinical practice is to standardise dispensers to ensure the required ABHR volume is delivered by a single dispenser action. A recent observational study of the ABHR volumes showed that the average ABHR volume used was only 1.09 ml (SD: 0.61), a dose similar to that delivered by the hospital’s automated ABHR dispensers (1.1ml) [ 46 ]. Yet, a recent study [ 47 ] investigating the dispensing performance of 22 wall-mounted ABHR dispensers commonly used in hospitals showed that the ABHR volume delivered by the dispensers was influenced by the ABHR format, the level of ABHR present in the container and the time lapse between dispenser uses.…”

Design and Development of an Automated Monitored Hand Hygiene System to Curb Infection Spread in Institutional Settings During COVID-19 Pandemic

“…Even Hydrogen Peroxide at 0.5% concentration has been reported to decrease the infection capability of human coronaviruses, when used for a minute [14] 2.6.Volume Some studies have reported that in a hospital setting, the volume of ABHR dispensed by the hospital's automated dispenser is close to 1.1 mL per dose and the ABHR dose is inversely related with the number of applications of ABHR per shift, but has no relationship with the hand size, although there is a concern that it might create a risk for people with larger hand size. [15]…”