Should Alcohol-Based Handrub Use Be Customized to Healthcare Workers’ Hand Size?

Bellissimo-Rodrigues, Fernando; Soule, Hervé; Gayet-Ageron, Angèle; Martin, Yves; Pittet, Didier

doi:10.1017/ice.2015.271

Cited by 37 publications

(74 citation statements)

References 7 publications

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“…Consistent with the findings of two previous studies, we did not find a correlation between hand surface area and log 10 RF values [ 5 , 6 ]. These findings do not support the recommendation by Bellisimo-Rodrigues et al that ABHR use should be customized to healthcare workers’ hand size [ 4 ]. These data do suggest that when evaluating ABHR efficacy, inclusion of participants with a broad range of hand sizes may ensure a more representative spread in product dry-times.…”

Section: Discussioncontrasting

confidence: 78%

“…Several groups have recently investigated the relationships between key ABHR use variables such as product volume, hand size, product dry-times, and log reduction factors using standard EN 1500 methodology [ 4 – 6 ]. These studies suggest that hand size and product dry-time are important variables, but the relative importance of each in determining ABHR efficacy remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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How long is enough? Identification of product dry-time as a primary driver of alcohol-based hand rub efficacy

Suchomel

Leslie

Parker

et al. 2018

Antimicrob Resist Infect Control

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BackgroundThe World Health Organization has called for the development of improved methodologies to evaluate alcohol-based handrub (ABHR) efficacy, including evaluation at “short application times and volumes that reflect actual use in healthcare facilities”. The objective of this study was to investigate variables influencing ABHR efficacy, under test conditions reflective of clinical use.MethodsThe test product (60% V/V 2-propanol) was evaluated according to a modified EN 1500 methodology, where application volumes of 1 mL, 2 mL, and 3 mL were rubbed until dry. Statistical analyses were performed to investigate the relative influences of product volume, hand size, and product dry-time on efficacy, and hand size and hand contamination on product dry-time.ResultsMean log10 reduction factors (SD) were 1.99 (0.66), 2.96 (0.84) and 3.28 (0.96); and mean dry-times (SD) were 24 s (7 s), 50 s (14 s), and 67 s (20 s) at application volumes of 1 mL, 2 mL, and 3 mL, respectively (p ≤ 0.030). When data were examined at the individual volunteer level, there was a statistically significant correlation between dry-time and log reduction factor (p < 0.0001), independent of application volume. There was also a statistically significant correlation between hand surface area and dry-times (p = 0.047), but no correlation between hand surface area and efficacy (p = 0.698).ConclusionsWhen keeping other variables such as alcohol type and concentration constant, product dry-time appears to be the primary driver of ABHR efficacy suggesting that dosing should be customized to each individual and focus on achieving a product dry-time delivering adequate efficacy.

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Section: Discussioncontrasting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

How long is enough? Identification of product dry-time as a primary driver of alcohol-based hand rub efficacy

Suchomel

Leslie

Parker

et al. 2018

Antimicrob Resist Infect Control

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“…Third, the amount we adopted as the adequate amount per HH event, 1.3 ml, is much less than the 3 ml said to be recommended by most ABHR manufacturers, and even larger amounts were recommended for HCWs with large hands in a study from Europe [42]. The WHO guidelines recommend 20 to 30 seconds for each hand rub event, but some recent reports show that a 15-second application time is equal to a 30-second application in terms of wettability of hands [43] and is not inferior in terms of reducing bacterial counts on hands under experimental conditions [44].…”

Section: Discussionmentioning

confidence: 96%

The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.

Suzuki

Morino²,

Morita

et al. 2020

Preprint

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Background: A World Health Organization (WHO) guideline-based multimodal hand hygiene (HH) initiative was introduced hospital-wide to a nonteaching Japanese hospital for 5 years. The objective of this study was to assess the effect of this initiative in terms of changes in alcohol-based hand rub (ABHR) consumption and the Hand Hygiene Self-Assessment Framework (HHSAF) score.Methods: The consumption of monthly hospital-wide ABHR was calculated in L per 1000 patient days (PDs). The change in ABHR consumption was analysed by an interrupted time series analysis with a pre-implementation period of 36 months and an implementation period of 60 months. The correlation between annual ABHR consumption and the HHSAF score was estimated using Pearson’s correlation coefficients.Results: The annual ABHR consumption was 4.0 (L/1000 PDs) to 4.4 in the pre-implementation period and 10.4 to 34.4 in the implementation period. The HHSAF score was 117.5 (out of 500) in the pre-implementation period and 267.5 to 445 in the implementation period. A statistically significant increase in the monthly ABHR consumption (change in slope: + 0.479 L/1000 PDs, p < 0.01) was observed with the implementation of the initiative. Annual ABHR consumption was strongly correlated with the annual HHSAF score (r = 0.971, p < 0.01).Conclusions: A 5-year WHO-based HH initiative significantly increased ABHR consumption. Our study suggested that the HHSAF assessment can be a good process measure to improve HH in a single facility, as ABHR consumption increased with the HHSAF score.

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“…A proposal for hand-size classification has been made already. 7 Each participant would initially have to determine how much volume is necessary to keep both hands wet (eg, for 20 or 30 seconds), resulting in a specific test volume per subject and application time. This volume would later be used for efficacy testing against the reference procedure.…”

Section: The Puzzle Of Volume Coverage and Application Time In Handmentioning

confidence: 99%

The Puzzle of Volume, Coverage, and Application Time in Hand Disinfection

Kampf

2017

Infect. Control Hosp. Epidemiol.

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Should Alcohol-Based Handrub Use Be Customized to Healthcare Workers’ Hand Size?

Cited by 37 publications

References 7 publications

How long is enough? Identification of product dry-time as a primary driver of alcohol-based hand rub efficacy

How long is enough? Identification of product dry-time as a primary driver of alcohol-based hand rub efficacy

The effect of a 5-year hand hygiene initiative based on the WHO Multimodal Hand Hygiene Improvement Strategy: an interrupted time-series study.

The Puzzle of Volume, Coverage, and Application Time in Hand Disinfection

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