Improved rates of compliance with hand antisepsis guidelines: A three-phase observational study

Hand antisepsis is arguably the single most effective means of preventing and controlling nosocomial infection. Yet it's often neglected, although nosocomial infections threaten the lives of approximately two million patients in the United States annually. Among the reasons health care workers give for noncompliance are the inconvenience and time involved in traditional soap-and-water handwashing and the drying effect this' method has on skin. These three researchers sought to discover whether making hand antisepsis a quicker and more convenient process would increase compliance. This 1999 observational study, which took place on two hospital intensive care units, established a baseline rate of soap-and-water handwashing compliance, then offered health care workers an alternative: hand degerming using a rinse-free, alcohol-based gel. Such gels are relatively inexpensive, and dispensers are easy to install and use. Seventy-three gel dispensers were installed inside and outside patient rooms, and compliance was evaluated over short- and long-term periods. The ready availability of the gel resulted in a sustained increase in hand antisepsis rates among health care workers. These findings support the use of these products as a viable method of increasing rates of hand antisepsis compliance.