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Gel Cleans Up

Hand gel increases hand cleaning among health-care workers

SATURDAY, June 16, 2001 (HealthDayNews) -- Doctors, nurses and other health-care workers are more likely to clean their hands when a sanitizing alcohol-based hand gel is available as an alternative to soap and water, says a new study from the University of California at San Diego (UCSD) Medical Center.

And if you don't think that's important, you should know that hand washing has been repeatedly identified as the single most effective means of controlling and preventing hospital-acquired infections.

"Hand washing and hand disinfection is a topic of great interest to the health-care community. It's also a topic of interest to the public. There is very good evidence that many types of organisms are transmitted by hands," says the study's lead author, Marguerite Jackson, a nurse and director of the department of education, development and research at the UCSD Medical Center.

"There are many times when health-care professionals don't wash their hands nearly as much as those of us who are in infectious-disease control would like them to,'' Jackson says.

The observational study was done over five months in two intensive-care units at the UCSD Medical Center. Before 73 gel dispensers were installed inside and outside patient rooms, health-care workers "sanitized" their hands in 39.6 percent of "patient contact situations."

Interestingly, the researchers found that physicians cleaned their hands less than nursing staffers, who cleaned their hands less than other staffers, such as radiation technicians and physical therapists.

Overall compliance rates increased to 52.6 percent in the two to six weeks after the alcohol-based hand gel was introduced as an alternative to soap and water in sinks. And compliance increased to 57 percent 10 to 14 weeks after the hand-gel dispensers were installed.

"What we found was that if you make a product easily accessible and available to busy health-care folks, that it does indeed increase compliance with hand de-germing,'' Jackson says.

The study was published in a recent issue of the American Journal of Nursing.

Time, availability of a sink, and competing priorities are among the reasons health-care professionals may be lax in their hand cleansing, Jackson says.

It may take only about 10 seconds for health-care workers to actually wash their hands with soap and water, but there's added time in getting to a sink and drying hands after washing them. The total time for that is about 45 seconds, Jackson estimates.

That seems trivial until you start adding it up for a health-care worker who should clean his or her hands before and after seeing a patient. You're up to 90 seconds now for each patient. Then multiply that by scores of patients each day and you can appreciate the time factor.

"When you use an alcohol gel product, you can dispense it on to your hands and rub your hands together while you are walking from one place to the next, so you actually lose no time at all in the process," Jackson says.

The alcohol in the gel rapidly kills any germs on the hands. But, the gel shouldn't replace soap and water in all cases.

"It [gel] does not take the place of hand washing by any means. There are many circumstances where hand washing is essential, particularly if the hands are visibly soiled or if the hands are going to be used for a very high-risk procedure like surgery,'' Jackson says.

The gels are a useful product, agrees Marsha Koopman, a nurse epidemiologist at the University of California at Davis Medical Center, in Sacramento.

They're easy to use and of special value in certain locations, such as an ambulance or a field situation, where there is no sink available, Koopman says. They're also handy for health-care workers such as visiting nurses, who can keep the hand gels in their cars.

What To Do

For more HealthDay stories on hand washing, click here.

You can find more information about the importance of hand washing and proper technique at the Mayo Clinic, or the University of California at Davis Medical Center.

SOURCES: Interviews with Marguerite Jackson, R.N., Ph.D., director, department of education, development and research, University of California at San Diego Medical Center; Marsha Koopman, R.N., M.H.A., nurse epidemiologist, University of California at Davis Medical Center, Sacramento; March 2001 issue of the American Journal of Nursing
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