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Hand antisepsis without decreasing efficacy by shortening the rub-in time of alcohol-based handrubs to 15 seconds

Harnoss, J.C.; Dancer, S.J.; Kaden, C.F.; Baguhl, R.; Kohlmann, T.; Papke, R.; Zygmunt, M.; Assadian, O.; Suchomel, M.; Pittet, D.; Kramer, A.

Authors

J.C. Harnoss

C.F. Kaden

R. Baguhl

T. Kohlmann

R. Papke

M. Zygmunt

O. Assadian

M. Suchomel

D. Pittet

A. Kramer



Abstract

Background
A previous study among neonatal intensive care unit (NICU) nurses showed that the antibacterial efficacy of alcohol-based handrubs (ABHR) can be achieved in 15 s instead of 30 s with a significant increase in the frequency of hand antisepsis. This study aimed to examine 15-s vs 30-s antisepsis performance by measuring microbial load on fingertips and compliance among nurses in a low-risk gynaecological ward.

Methods
An independent trained observer monitored the frequency and compliance with hand antisepsis during shifts in a crossover design. Fingertips including thumbs were rinsed in soy broth before hand rubbing at the beginning of a shift and then hourly to determine the bacterial load. Performance activity was assigned to the contamination class of the Fulkerson scale. Immediately before the lunch break, volunteers cleaned their hands for a randomly determined application time of 15 or 30 s.

Results
Examination of bacterial load on fingertips revealed no difference between 15 vs 30 s application time. Controlled hand antisepsis before the lunch break also showed no difference in efficacy for either test series. Participants rubbing for 15 s were more likely to perform hand antisepsis compared with those rubbing for 30 s ( P=0.2). The compliance increased from 54.7% to 69.5% in the 15-s trial.

Discussion
Shortening the duration for hand antisepsis did not decrease efficacy. Shortening the application time to 15 s should be considered within the critical components of a successful multimodal intervention strategy to improve hand-hygiene compliance in clinical practice.

Journal Article Type Article
Acceptance Date Sep 4, 2019
Online Publication Date Sep 9, 2019
Publication Date 2020-04
Deposit Date May 15, 2020
Publicly Available Date Nov 23, 2020
Journal Journal of Hospital Infection
Print ISSN 0195-6701
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 104
Issue 4
Pages 419-424
DOI https://doi.org/10.1016/j.jhin.2019.09.004
Keywords Hand antisepsis, Shortened application, Compliance
Public URL http://researchrepository.napier.ac.uk/Output/2661617

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