Summary
Background
Effective alcohol-based hand rubs (ABHRs) and healthcare worker compliance with hand
hygiene guidelines are important in the prevention of infection transmission in healthcare
settings. Compliance to hand hygiene guidelines is affected by many factors including
education, ABHR availability, time pressure, skin health, and user acceptance of the
sensory properties of ABHRs during and after application.
Aim
To examine the effect of ABHR format (gel/foam/liquid) and dose (0.7 mL, 1.5 mL, 3 mL)
on its sensory properties and acceptability, and to consider how this might affect
healthcare workers' hand hygiene compliance.
Methods
Sensory descriptive analysis established key sensory differences between ten market-leading
ABHRs (three gels, four foams, two liquids, one aerosol foam). Focus groups reinforced
these differences.
Findings
All formats were less desirable at the highest dose as they were more difficult to
handle than the lower doses. Foams and gels became stickier, less clean-feeling and
slower to dry at higher doses. Liquids gave a cleaner, smoother, more moisturized
feel, but the increased difficulty in handling and applying the product negated these
benefits. Overall, the gel and foam formats were more desirable than the liquid. The
key desirable properties include: fast absorption, soft/moisturized hand feel, not
sticky, clean feel, and low smell.
Conclusion
The 1.5 mL dose yielded the most acceptable properties with no extreme negative consequences.
The foam provided the benefits of both the liquid and gel and combined them into a
more widely acceptable format that may lead to greater hand hygiene compliance.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hospital InfectionAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Doctor, do you have a moment?.Med J Aust. 2014; 200: 1-4
- An average hand hygiene day for nurses and physicians: the burden is not equal.Am J Infect Control. 2016; 44: 777-781
- Systematic review of studies on compliance with hand hygiene guidelines in hospital care.Infect Control Hosp Epidemiol. 2010; 31: 283-294
- The World Health Organization hand hygiene observation method.Am J Infect Control. 2009; 37: 827-834
- Effect of topical treatments on irritant hand dermatitis in health care workers.Am J Infect Control. 2009; 57: 842-850
- Compliance with hand hygiene: reference data from the national hand hygiene campaign in Germany.J Hosp Infect. 2016; 92: 328-331
- Hand hygiene – comparison of international recommendations.J Hosp Infect. 2001; 48: 23-38
- WHO guidelines on hand hygiene in health care. First global patient safety challenge. Clean care is safer care.2009 (Available at:) ([last accessed July 2016])
- Skin reactions related to hand hygiene and selection of hand hygiene products.Am J Infect Control. 2006; 34: 627-633
- Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use.Br J Dermatol. 2000; 143: 546-550
- A joint, multilateral approach to improve compliance with hand hygiene in 4 countries within the Baltic region using the World Health Organization’s save lives: clean your hands model.Am J Infect Control. 2016; 44: 1208-1213
- Compliance with hand disinfection and its impact on hospital-acquired infections.J Hosp Infect. 2001; 48: 40-46
- Improving hand hygiene in a paediatric hospital: a multimodal quality improvement approach.BMJ. 2012; 21: 171-176
- Role of hand hygiene in healthcare-associated infection prevention.J Hosp Infect. 2009; 73: 305-315
- Chemical disinfectants and antiseptics – hygienic handrub – test method and requirements.2013 (phase 2/step 2)
- Standard test method for evaluation of the effectiveness of health care personnel hand wash formulations.ASTM International, West Conshohocken, PA2013
- Less and less-influence of volume on hand coverage and bactericidal efficacy in hand disinfection.BMC Infect Dis. 2013; 13: 472
- Dose considerations for alcohol-based hand rubs.J Hosp Infect. 2017; 95: 175-182
- Sensory evaluation practices.3rd ed. Elsevier, San Diego2004
- Descriptive analysis in sensory evaluation.John Wiley & Sons, Chichester2018
- Using thematic analysis in psychology.Qual Res Psychol. 2006; 3: 77-101
- The influence of cosmetic additives on the acceptability of alcohol-based hand disinfectants.J Hosp Infect. 1991; 18: 57-63
- Clinical double-blind trial on the dermal tolerance and user acceptability of six alcohol-based hand disinfectants for hygienic hand disinfection.J Hosp Infect. 2002; 51: 14-20
- Hand disinfection according to the European Standard EN 1500 (hygienic handrub): a study with Gram-negative and Gram-positive test organisms.Int J Hyg Environ Health. 2001; 204: 123-126
- Prevalence of hand dermatitis in inpatient nurses at a United States hospital.Dematitis. 2007; 18: 140-142
- Does hand care ruin hand disinfection?.J Hosp Infect. 2001; 48: 37-39
Article info
Publication history
Published online: July 15, 2018
Accepted:
July 7,
2018
Received:
March 7,
2018
Identification
Copyright
© 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
