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Nursing preference for alcohol-based hand rub volume

Published online by Cambridge University Press:  19 September 2019

Richard A. Martinello Open the ORCID record for Richard A. Martinello [Opens in a new window] ,
James W. Arbogast ,
Kerri Guercia ,
Albert E. Parker  and
John M. Boyce
Richard A. Martinello*
Affiliation:
Yale School of Medicine, New Haven, Connecticut Yale New Haven Hospital, New Haven, Connecticut
James W. Arbogast
Affiliation:
GOJO Industries, Akron, Ohio
Kerri Guercia
Affiliation:
Yale New Haven Hospital, New Haven, Connecticut
Albert E. Parker
Affiliation:
Center for Biofilm Engineering and Department of Mathematical Sciences, Montana State University, Bozeman, Montana
John M. Boyce
Affiliation:
J.M. Boyce Consulting, Middletown, Connecticut
*
Author for correspondence: Richard A. Martinello, MD, Yale School of Medicine, Department of Internal Medicine (Infectious Diseases), 20 York Street, New Haven, CT 06510. Email: Richard.Martinello@yale.edu
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Abstract

Background:

The effectiveness of alcohol-based hand rub (ABHR) is correlated with drying time, which depends on the volume applied. Evidence suggests that there is considerable variation in the amount of ABHR used by healthcare providers.

Objective:

We sought to identify the volume of ABHR preferred for use by nurses.

Methods:

A prospective observation study was performed in 8 units at a tertiary-care hospital. Nurses were provided pocket-sized ABHR bottles with caps to record each bottle opening. Nurses were instructed to use the volume of ABHR they felt was best. The average ABHR volume used per hand hygiene event was calculated using cap data and changes in bottle mass.

Results:

In total, 53 nurses participated and 140 nurse shifts were analyzed. The average ABHR dose was 1.09 mL. This value was greater for non-ICU nurses (1.18 mL) than ICU nurses (0.96 mL), but this difference was not significant. We detected no significant association between hand surface area and preferred average dose volume. The ABHR dose volume was 0.006 mL less per use as the number of applications per shift increased (P = .007).

Conclusions:

The average dose of ABHR used was similar to the dose provided by the hospital’s automated dispensers, which deliver 1.1 mL per dose. The volume of ABHR dose was inversely correlated with the number of applications of ABHR per shift and was not correlated with hand size. Further research to understand differences and drivers of ABHR volume preferences and whether automated ABHR dosing may create a risk for people with larger hands is warranted.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1248 - 1252
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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