Randomized Controlled Trial of Antiseptic Hand Hygiene Methods in an Outpatient Plastic Surgery Clinic
Paul J. Therattil, M.D., Janet H. Yueh, M.D., Anthony M. Kordahi, B.A., Deepa V. Cherla, M.D., Edward S. Lee, M.D., Mark S. Granick, M.D..
Rutgers - New Jersey Medical School, Newark, NJ, USA.
PURPOSE: Hand hygiene is integral to preventing infection in clinical settings. However, studies have demonstrated poor compliance with hand hygiene measures secondary to skin irritation and lack of time. A long-acting hand sanitizer could improve compliance. The objective of this trial was to determine the efficacy of a single-use, long-acting antiseptic in comparison to standard multiple-use hand hygiene methods in an outpatient surgical setting.
METHODS: A prospective, randomized controlled trial was performed in our outpatient plastic surgery clinic comparing the efficacy of soap-and-water hand washing (SW), ethyl alcohol-based sanitizer (EA), and a long-acting benzalkonium chloride-based sanitizer (BC). Subjects included clinic personnel, who were followed throughout the course of a 3-hour clinic session with hourly hand bacterial counts taken.
RESULTS: During the course of the trial, 68 subjects properly completed the clinic session utilizing one of the hand hygiene methods (17 SW, 22 EA, and 29 BC). There was no difference between hand bacterial counts using the different hygiene methods at four hourly time points (p > 0.05). Hand bacterial counts increased significantly over the 3-hour clinic session with SW (6.24 to 31.41 CFU, p < 0.05), EA (6.09 to 25.96 CFU, p < 0.05), and BC (4.03 to 28.83 CFU, p < 0.05).CONCLUSION: A single-use, long-acting hand sanitizer has similar efficacy to standard multiple-use hand hygiene methods in an outpatient surgical setting. Hand bacterial counts increased significantly over the course of the 3-hour clinic session regardless of the hand hygiene measure used.
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