Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit

• Published in: American journal of respiratory and critical care medicine 2000-07, Vol.162 (1), p.324-327
• Main Authors: MAURY, E, ALZIEU, M, BAUDEL, J. L, HARAM, N, BARBUT, F, GUIDET, B, OFFENSTADT, G
• Format: Article
• Language: English
• Subjects: alcohols; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Attitude of Health Personnel; Biological and medical sciences; Disinfection - methods; Disinfection - standards; Emergency and intensive care: techniques, logistics; Ethanol; Guideline Adherence - statistics & numerical data; Hand Disinfection; Humans; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Intensive Care Units - standards; Medical sciences; Paris; Personnel, Hospital; Prospective Studies; Solutions
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/ajrccm.162.1.9908118

We investigated whether rubbing with an alcohol solution increases compliance with hand disinfection in a medical intensive care unit (MICU). During a first period (P1), hand disinfection was achieved only through conventional washing, whereas during a second period (P2), hand disinfection could be achieved either through conventional washing or rubbing with an alcohol solution. There were 621 opportunities for hand disinfection during P1 and 905 opportunities during P2. General compliance during P1 was 42.4%, and reached 60.9% during P2 (p < 0.001). This improvement was observed among nurses (45.3% versus 66.9%, p < 0.001), senior physicians (37. 2% versus 55.5%, p < 0.001), and residents (46.9% versus 59.1%, p = 0.03). Acceptability and tolerance were evaluated through the answers to an anonymous questionnaire distributed to all 53 health care workers in the MICU. Rubbing with alcohol solution was an easy procedure (100% of responses) and induced mild side effects in less than 10% of respondents. In a complementary study conducted 3 mo after the first one, compliance remained better than during P1 (51. 3% versus 42.4%, p = 0.007). These findings suggest that rubbing with alcohol solution increases compliance with hand disinfection, and that it could be proposed as an alternative to conventional handwashing in the MICU.