Routine handwashing with antimicrobial agent and water or alcoholic solution? : a clinical trial of its effectiveness in a general hospital in Hong Kong

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Routine handwashing with antimicrobial agent and water or alcoholic solution? : a clinical trial of its effectiveness in a general hospital in Hong Kong

 

Author: Leung, Fat-ying
Title: Routine handwashing with antimicrobial agent and water or alcoholic solution? : a clinical trial of its effectiveness in a general hospital in Hong Kong
Degree: M.Sc.
Year: 2001
Subject: Hand washing -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Nursing and Health Sciences
Pages: xiv, 74 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1554861
URI: http://theses.lib.polyu.edu.hk/handle/200/4709
Abstract: Although hand hygiene is one of the most important interventions to reduce transmission of infectious agents, health care workers wash less and for shorter duration than recommended. The discrepancy between theory and practice in handwashing continues to exist. Approaches to improve hand hygiene have not been effective. Thus, development of new approaches to improve hand hygiene and reduce nosocomial infections is important. This study aims at assessing the microbacterial load of hands after routine patient care procedures in clinical areas and to evaluate the effectiveness of alcoholic hand disinfection (AHD) by comparing with the routine handwashing with antimicrobial agent and water (RHW). One hundred and twenty-eight eligible health care workers were randomly selected from clinical wards to participate in this clinical trial study. Imprints of the fingertips were collected before and after the patient care procedures (PCP) to assess the degree of hand contamination. Then the subjects were randomly assigned to wash their hands either by RHW or AHD before they imprint the fingertips on agar plates again. This was to compare the effectiveness of these two handwashing methods. Results showed that there was an increase in microbial load on hands after PCP (t=2.339, p=0.021). PCP that associated with higher rates of hand contamination included direct patient contact, skin contact, respiratory care, blood sampling or intravenous injections or care of the intravenous lines. If dividing the PCPs into categories, only direct patient contact had significantly increase the microbial load on hands. The degree of hand contamination was affected by the intensity of patient skin contact, handwashing before PCP, duration of the PCP, wearing gloves, nature of wards and length of hospital stay of patient. Both RHW and AHD could significantly decrease the microbial load on hands. Results also showed that both methods did not differ significantly in their effectiveness to decrease microbial load. Based on the findings of the present study, health care workers did contaminate their hands during patient care procedures. The level of contamination is dependent on the intensity of patient contacts and types of patient care. Therefore, the importance of handwashing should continue to be stressed in daily care practices. AHD can be used as an option for regular handwashing as it has similar anitmicrobial action. Furthermore, the advantages of reduced handwashing time, easily assessable, simplicity, render it a desirable alternative for health care workers with high workloads to wash their hands more frequently.

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