Effectiveness of

Hand Sanitizer
GNRS 507: Scientific
Writing
Presented by: Jenny Hsu

Hand Hygiene
O Infections spread by hands of

healthcare workers account for up to

40% of health care-associated
infections.7
O Hand hygiene is one of the most

widely used interventions to prevent

the transmission of disease within
the healthcare setting.
O Hand washing with soap and water
O Alcohol-based hand sanitizers (ABHS)

Hand Hygiene
O WHO & CDC promote use of ABHS

during patient care to prevent

transmission of disease 2
O What is the policy at your clinical

site?

PICO Question
O In medical settings, is

ABHS as effective as
hand washing with soap
and water in decreasing
the transmission of
harmful bacteria and
viruses from nurses to
patients?

The Findings
O ABHS was an effective alternative to hand

washing with soap and water to prevent

the spread of pathogenic bacteria between
patients by HCWs in acute hospital
settings 3,4,5
O ABHS was not just comparable, but was

also more efficient than hand washing

since it had the benefit of being more time
saving 3

The Findings
(continued)
O Increased use of ABHS over hand washing

with soap may have caused an increase in

norovirus outbreaks in long term care
facilities 1
O retrospective study design
O potential recall bias by the Infection Preventionists

O ABHS was able to inactivate certain viruses,

including norovirus, in-vitro

O ABHS were superior to antimicrobial soaps

Application to Nursing
O Hospitals and medical centers

adopt WHO/ CDC

recommendations
O No current standards of

regarding usage of ABHS

O Vary based on staff preference,

procedure, facility

Application to Nursing
continued
O ABHS should be promoted as a standard

for hand hygiene for nurses in acute

hospital settings 3,4,5
O ABHS should be preferred method of

hand hygiene in certain facilities

O Saves time
O High workload, lack of time
O May increase compliance of hand hygiene

Limitations
O Findings regarding efficacy of ABHS against

spread of norovirus are conflicting.

O Prevents replacement of policies on hand washing

with ABHS
O Sends mixed messages to nurses about which
hand hygiene intervention to use
O Further prospective studies needed

O The WHO and CDC recommend using ABHS for

hand hygiene when hands are not visibly soiled

O Promote awareness of limitations of ABHS

Gaps in Research
O Health care workers include physicians,

nurses, and other medical staff

1,3,4,5

O Studies that look primarily at nurses and

use of ABHS in nursing tasks lacking

O Different scope of practice, more direct

contact, different tasks, different facilities

Gaps in Research
O Most research has focused on sterile hand

hygiene in surgical settings

O Larger variety of different types of hand

hygiene interventions in different medical

settings needed
O More studies will help set standard regarding

ABHS usage in healthcare facilities and

improve evidence-based practice

References
1. Blaney, D., Daley, E., Kirkland, K., Tongren, J., Kelso, P., & Talbot, E. (2011).Use of alcohol- based
hand sanitizers as a risk factor for norovirus outbreaks in long-term care facilities in northern New
England: December 2006 to March 2007. American Journal of Infection Control, 39 (4), 296-301.
doi:10.1016/j.ajic.2010.10.010
2. Boyce, J.M., & Pittet, D. (2002). Guideline for and hygiene in health-care settings:
Recommendations of the Healthcare Infection Control Practices Advisory Committee and the
HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR Morbid Mortal Weekly Report, 51(RR-16),
1-44.
3. Chow, A., Onyebuchi, A.A., Chan, S., Poh, B., Krishnan, P., Ng, W., ...Ang, B. (2012). Alcohol
handrubbing and chlorhexidine handwashing protocols for routine hospital practice: A randomized
clinical trial of protocol efficacy and time effectiveness. American Journal of Infection Control, 40,
800-805. doi:10.1016/j.ajic.2011.10.005
4. Creamer, E., Dorrian, S., Dolan, A., Sherlock, O., Fitzgerald-Hughes, D., Thomas, T.,
Humphreys, H. (2010). When are the hands of healthcare workers positive for methicillin-resistant
Staphylococcus aureus? Journal of Hospital Infection, 75, 107-111. doi:10.1016/j.jhin.2009.12.005
5. Hossein, S., & Sajjad R. (2009). Hand washing versus hand hygiene in intensive care unit: A
clinical trial. Journal of Critical Care, 24 (3), 15-17. doi:10.1016/j.jcrc.2009.06.007
6. Steinmann, J., Paulmann, D., Becker, B., Bischoff, B., Steinmann, E., & Steinmann, J. (2012).
Comparison of virucidal activity of alcohol-based hand sanitizers versus antimicrobial hand soaps in
vitro and in vivo. Journal of Hospital Infection, 82, 277-280. doi:10.1016/j.jhin.2012.08.005
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