Content area
Full Text
ABSTRACT
Universal precautions require that perioperative health care personnel wash their hands before and after all patient contact. Time constraints, however, can make adhering to universal precautions, including proper hand washing, difficult. Some perioperative health care workers, therefore, routinely use rinse-free hand sanitizers to supplement normal hand washing. This study evaluated immediate and persistent antimicrobial effectiveness of two alcohol-containing hand sanitizers and a novel surfactant, allantoin, benzalkonium chloride (SAB) hand sanitizer using a federally approved effectiveness protocol. Results indicate that all three products were equally effective after a single application. After repeated use, the alcoholcontaining sanitizers did not meet federal performance standards, and the alcohol-free sanitizer did. These properties and others illustrated in this article indicate that the nonflammable, alcohol-free SAB hand sanitizer is the most favorable of the rinse-free hand sanitizer formulas for normal hand washing. AORN J 68 (August 1998) 239-251.
Following universal precautions is an integral part of OR staff members' responsibilities in perioperative patient care. The precautions mandate routine hand washing with soap and water before and after all patient contact, and especially before invasive procedures. Although intended to reduce the postoperative risk of infection of healing incisions and wounds, universal precautions, including hand washing, are followed only 55% of the time in the nation's hospitals.'
The contributing factors behind this insufficient hand washing are manifold; however, identified principal causes include the following.
Direct patient caregivers are handling an excessive patient load. Conservative estimates indicate that physicians attend to 20 to 30 patients per day, and other health care personnel (eg, nurses, physical therapists, respiratory therapists) may have as many as 200 patient contacts per day.
The repeated hand washing required for that volume of patients causes dryness and subsequent microabrasions of the skin.2
The skin on the hands has a short period of time to recover between washings.
These factors, among others, have led to a great increase in the use of rinse-free instant hand sanitizers as a supplement to proper hand washing with soap and water.
The most widely used hand sanitizers are gels and foams that rely on alcohol as the main antimicrobial ingredient. Alcohol, however, solubilizes and strips away sebum and lipids that guard against bacterial infections of the skin.3 Extensive use of alcohol-containing hand sanitizers...