Waterless hand soap a boon for medics

July 29, 2001|By Sandra G. Boodman, Washington Post.

Could a waterless, alcohol-based hand cleaner, rather than antiseptic soap and water, solve the seemingly intractable problem of getting doctors and nurses to wash their hands between seeing patients?

That's the implication of a study by researchers at Columbia University in New York, who tested both products on the staff of two intensive-care units of a large, unnamed academic medical center.

Fifty staff members were randomly assigned to use one of the two products for four weeks. They were periodically observed by researchers who timed how long they washed and checked for deviations from standard infection-control procedures, such as failing to clean all skin surfaces while washing and touching the surface of the sink immediately afterward. Bacterial cultures of the staff members' hands and visual assessments of skin condition also were performed.

Lead investigator Elaine L. Larson and her colleagues found that waterless washes that contain alcohol and skin softeners were easier on the skin, faster to use and just as effective as their harsher, detergent-based counterparts in killing harmful bacteria that can be transmitted to patients. In addition they found that there were fewer deviations from accepted practice in the group using the alcohol cleaner.

The team also found that the alcohol-based product made it easier to don gloves after washing; 70 percent of those who used this cleaner said they preferred it to the regular wash.

Few American hospitals stock alcohol-based cleaners, which are widely used in Europe, the authors report in Critical Care Medicine. They suggest that further research is needed to assess what effect use of these hand cleaners might have on the rate of infections acquired by hospitalized patients.