Reducing hospital-associated infections through hand hygiene : a comparison of alcoholic hand rub and hand washing with soap and water

Abstract

Hand hygiene is one of the most important aspects in reducing hospital acquired infections. Currently, hospital acquired infections pose a great threat to patients, leading to a longer stay in hospitals, a rise in health care costs and mortality increase. Alcohol hand rub is being promoted in Mater Dei hospital as the best product to reduce microorganism transfer. The purpose of this study is to find out whether alcohol hand rub is the best product to use in hospitals. The research question looks at whether health professionals' application of alcohol-based hand rub is more effective than hand washing with soap and water in reducing patients' risk of acquiring hospital-associated infection. The literature review was done thr~ugh an extensive search by usmg several electronic databases. Six of the keywords used included; hand hygiene, hand washing, alcohol hand rub, plain soap, cross contamination and hospital environment. The evidence retrieved was identified, filtered and ranked according to strength. In total six studies which fit the criteria were retrieved including: four randomized control trials, a cross over design and an observational study. The studies were all critically appraised through the Casp tool system. The inclusion criteria included those studies which were written in English, had full text reading and also those studies which were betweenl990-2011. Studies which were done not in a hospital setting and also those which used chlorehexidine soap as a hand washing product were excluded. The overall findings show the superior efficiency of alcohol hand rub against plain soap and water in reducing transfer of bacteria from the hands. Only one study was against alcohol hand rub as being the most effective option for hand hygiene. However the researchers tested on the bacterium Clostridium difficile and were proofed that this type of bacterium can only be removed by plain soap and water because it is a spore forming bacteria. The findings from this literature review show that alcohol hand rub is more effective and is time efficient but this retrieved information needs to be promoted better to health care workers in order to decrease hospital acquired infections as much as possible. Compliance and behavioural aspects of the health care worker against hand hygiene was also pointed out by researchers. This aspect resulted in showing that there is lack of knowledge on hand hygiene and many obstacles which influence health care workers compliance to hand hygiene at the appropriate moments.