Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-12-01T00:31:23.491Z Has data issue: false hasContentIssue false

Quantity of Soap as a Variable in Handwashing

Published online by Cambridge University Press:  02 January 2015

Elaine L. Larson*
Affiliation:
School of Nursing, The Johns Hopkins University, Baltimore, Maryland
Paul I. Eke
Affiliation:
Division of Infectious Disease, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
Mary P. Wilder
Affiliation:
Virginia Polytechnic Institute and State University, Blacksburg, Virginia
Barbara E. Laughon
Affiliation:
Division of Infectious Disease, School of Medicine, The Johns Hopkins University, Baltimore, Maryland
*
The Johns Hopkins University, School of Nursing, 600 N. Wolfe St., Baltimore, MD 21205

Abstract

The purposes of this study were to assess the effect of two quantities (1 mL or 3 mL) of four different handwashing products on reductions in log colony-forming units (CFU) from the hands and to determine the amount of liquid soap used for handwashing by personnel in one hospital. First, 40 subjects were assigned by block randomization to one of four handwashing products (4% chlorhexidine gluconate in a detergent base, two alcohol hand rinses, and a liquid, nonantimicrobial soap) to be used in either 1 mL or 3 mL amounts per wash. Each subject washed his or her hands 15 times per day for five days. After one and five days of handwashing there were significant reductions over baseline in log CFU between handwashing products (P<0.001). Additionally, subjects using 3 mL of antiseptic soap had significantly greater reductions in log CFU than those using 1 mL (P<0.001). Among subjects using control liquid soap there was no such dose response. Second, a survey of 47 members of a hospital nursing staff from nine specialty areas and ten individuals in the general population was conducted to measure amounts of two liquid soaps used for handwashing. Amount of soap ranged from 0.4 to 9 mL per handwash. Personnel working in clinical areas where patients were at high risk for nosocomial infection used significantly more soap than did others (P<0.05). We conclude that quantity of soap used for handwashing is one variable influencing the microbial counts on hands, and that the quantity of soap used by health care personnel varies considerably.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Gamer, JS, bavero, MS, Guideline for Handwashing ami Hospital Environmental Control. Atlanta, Centers for Disease Control, 1985.Google Scholar
2.Soule, BM (ed): The APIC Curriculum for Infection Control Practice. Dubuque. Kendall/Hum, 1983, pp 771, 792, 854.Google Scholar
3.Soulsby, ME. Barneit, JB. Maddox, S, The antiseptic efficacy of chloroxylcnol-containing vs. chlorhexidine gluconaie-containing surgical scrub preparations. Infect Control 1986:7:223228.Google Scholar
4.Morrison, AJ, Gratz, J, Cabezudo, I, et al: The efficacy of several new handwashing agents for removing nontransient bacterial flora from hands. Infect Control 1986;7:268272.Google Scholar
5.Dineen, P, Handwashing degerming: A comparison of povidone-iodine and chlorhexidine. Clin Pharmacol Ther 1978:23:6367.CrossRefGoogle ScholarPubMed
6.Eilzen, HE, Ritter, MA, French, ML, et al: A microbiological in-use comparison of surgical handwashing agents. J Bone Joint Surg 1979;61A,403406.Google Scholar
7.Larson, EL, Eke, PI, Laughon, B, Efficacy of alcohol-based hand rinses under frequent-use conditions. Antimicrob Agents Chemother 1986;30:542544.Google Scholar
8.Larson, EL. Strom, MS, Evans, CA, Analysis of three variables in sampling solutions used to assay bacteria of hands. J Clin Microbiol 1980;12:355300.Google Scholar
9.SPSS Inc: Users Guide: SPSSX, ed 2. New York. McGraw-Hill Book Company. 1986.Google Scholar
10.Ojajarvi, J, The importance of soap selection for unitine hand hygiene in hospital. J Hyg 1981;85:275283.Google Scholar
11.Larson, E, Killien, M, Factorsinffuencing handwashing behavior of patient care personnel. Am J Infect Control 1982;10:9399.Google Scholar
12.Meers, PD, Yeo, GA, Shedding of bacteria and skin squames after handwashing. J Hyg 1978;81:99105.Google Scholar
13.Maki, DG. Stevens, JA, Nosocomial colonization of cardiac surgen' and cardiology patients by ineihicillin-resislant coagulase-negative staphylococci. Proceedings of 24th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC.) 1984; abstr. # 472. p 176.Google Scholar
14.Larson, EL, McGinley, KJ, Foglia, AR, et al: Composition and antimicrobial resistance of skin flora in hospitalized and healthy adults. J Clin Microbiol 1980;23:604608.Google Scholar
15.Larson, EL, McGinley, KJ, Leyden, JJ, et al: Skin colonization with antibiotic-resistant (J K Group) and antibiolic-sensitive lipophilic diphtheroids in hospitalized and normal adults, J Infect Dis 1986;153:701706.Google Scholar
16.Larson, E, McGinley, K. Grove, G, et al: Physiologic, microbiologic, and seasonal effects of handwashing on the skin of health care personnel. Am J Infect Control 1986;14:5159.Google Scholar
17.Liu, C, The untamable staphylococci: Continuous problems in infectious disease. Compr Ther 1984;10:4954.Google Scholar
18.Noel, GJ, Edelson, PH, Staphylococcus epidermidis bacteremia in neonates: Further observations anil the occurrence of focal infection. Pediatrics 1984;74:832837.Google Scholar
19.Maki, DG, Hecht, JA, Comparative study of handwasliing with chlorhexidine, povidone-iodine, and nongermicidal soap for prevention of nosocomial infection. Clin Res 1982;30:303A.Google Scholar
20.Massanari, RM. Hierholzer, WJ, A crossover comparison of antiseptic soaps on nosocomial infection rates in intensive care unit. Am J Infect Control 1984;12:247248.Google Scholar