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Nursing preference for alcohol-based hand rub volume

Published online by Cambridge University Press:  19 September 2019

Richard A. Martinello Open the ORCID record for Richard A. Martinello [Opens in a new window] ,
James W. Arbogast ,
Kerri Guercia ,
Albert E. Parker  and
John M. Boyce
Richard A. Martinello*
Affiliation:
Yale School of Medicine, New Haven, Connecticut Yale New Haven Hospital, New Haven, Connecticut
James W. Arbogast
Affiliation:
GOJO Industries, Akron, Ohio
Kerri Guercia
Affiliation:
Yale New Haven Hospital, New Haven, Connecticut
Albert E. Parker
Affiliation:
Center for Biofilm Engineering and Department of Mathematical Sciences, Montana State University, Bozeman, Montana
John M. Boyce
Affiliation:
J.M. Boyce Consulting, Middletown, Connecticut
*
Author for correspondence: Richard A. Martinello, MD, Yale School of Medicine, Department of Internal Medicine (Infectious Diseases), 20 York Street, New Haven, CT 06510. Email: [email protected]
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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.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1248 - 1252
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

Macinga, DR, Shumaker, DJ, Werner, HP et al. The relative influences of product volume, delivery format and alcohol concentration on dry-time and efficacy of alcohol-based hand rubs. BMC Infect Dis 2014;14:511.CrossRefGoogle ScholarPubMed
Wilkinson, MAC, Ormandy, K, Bradley, CR, Fraise, AP, Hines, J. Dose considerations for alcohol-based hand rubs. J Hosp Infect 2017;95:175–182.CrossRefGoogle ScholarPubMed
Suchomel, M, Leslie, RA, Parker, AE, Macinga, DR. How long is enough? Identification of product dry-time as a primary driver of alcohol-based hand rub efficacy. Antimicrob Resist Infect Control 2018;7:65.CrossRefGoogle Scholar
Kohan, C, Ligi, C, Dumigan, DG, Boyce, JM. The importance of evaluating product dispensers when selecting alcohol-based handrubs. Am J Infect Control 2002;30:373–375.CrossRefGoogle ScholarPubMed
Leslie, RA, Donskey, CJ, Zabarsky, TF et al. Measuring alocohol-based hand rub volume used by healthcare workers in practice. Antimicrob Resist Infect Control 2015;7:P295.CrossRefGoogle Scholar
Dalziel, C, McIntyre, J, Chand, AG, McWilliam, S, Ritchie, L. Validation of a national hand hygiene proxy measure in NHS Scotland. J Hosp Infect 2018;98:375–377.CrossRefGoogle ScholarPubMed
Stahmeyer, JT, Lutze, B, von, LT, Chaberny, IF, Krauth, C. Hand hygiene in intensive care units: a matter of time? J Hosp Infect 2017;95:338–343.CrossRefGoogle Scholar
Macdonald, DJ, Mckillop, EC, Trotter, S, Gray, AJ. One plunge or two? Hand disinfection with alcohol gel. Int J Qual Health Care 2006;18:120–122.CrossRefGoogle ScholarPubMed
Goroncy-Bermes, P, Koburger, T, Meyer, B. Impact of the amount of hand rub applied in hygienic hand disinfection on the reduction of microbial counts on hands. J Hosp Infect 2010;74:212–218.CrossRefGoogle ScholarPubMed
Kampf, G, Ruselack, S, Eggerstedt, S, Nowak, N, Bashir, M. Less and less—influence of volume on hand coverage and bactericidal efficacy in hand disinfection. BMC Infect Dis 2013;13:472.CrossRefGoogle ScholarPubMed
Bellissimo-Rodrigues, F, Soule, H, Gayet-Ageron, A, Martin, Y, Pittet, D. Should alcohol-based handrub use be customized to healthcare workers’ hand size? Infect Control Hosp Epidemiol 2016;37:219–221.CrossRefGoogle ScholarPubMed
Zingg, W, Haidegger, T, Pittet, D. Hand coverage by alcohol-based handrub varies: volume and hand size matter. Am J Infect Control 2016;44:1689–1691.CrossRefGoogle ScholarPubMed
Lee, JY, Choi, JW, Kim, H. Determination of hand surface area by sex and body shape using alginate. J Physiol Anthropol 2007;26:475–483.CrossRefGoogle ScholarPubMed
Reilly, JS, Price, L, Lang, S et al. A pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute hospital care in the United Kingdom. Infect Control Hosp Epidemiol 2016;37:661–666.CrossRefGoogle ScholarPubMed
Pittet, D, Allegranzi, B, Sax, H et al. Double-blind, randomized, crossover trial of 3 hand rub formulations: fast-track evaluation of tolerability and acceptability. Infect Control Hosp Epidemiol 2007;28:1344–1351.CrossRefGoogle ScholarPubMed
Macinga, DR, Edmonds, SL, Campbell, E, Shumaker, DJ, Arbogast, JW. Efficacy of novel alcohol-based hand rub products at typical in-use volumes. Infect Control Hosp Epidemiol 2013;34:299–301.CrossRefGoogle ScholarPubMed