ALCOHOL BASED HAND RUBS

INTRODUCTION
• Nosocomial infection(NI) rate are often higher for intensive care unit (ICU) than other units of hospitals,
and hands of health-care workers (HCWs) play a major role in the transmission of the infections.
• Practicing hand hygiene is a simple and yet an effective way to prevent infections. Cleaning your hands
can prevent the spread of germs, including those that are resistant to antibiotics and are becoming
difficult, to treat. On average, healthcare providers protect yourself and your patients from potentially
deadly germs by cleaning your hands. Alcohol-based hand sanitizers are the preferred method for
cleaning your hands in most clinical situations. Wash your hands with soap and water whenever they are
visibly dirty, before eating, and after using the restroom. Alcohol- based hand sanitizers are used more
after touching a patient from a room to the other or after contact with blood, body fluids or
contaminated surfaces
PICOT
• PICOT question: Is the use of alcohol- based hand rubs as effective as hand washing in reducing
Nosocomial infections in patients on a Surgery unit?
• P: Adult patients on a Surgery floor
• I: Use of alcohol based rubs by healthcare providers
• C: Hand washing
• O: Reduction in Nosocomial infections
• T : Length of hospital stay
ORGANISATIONAL READINESS FOR EBP

• Organizational readiness is a state of preparedness for change, psychologically and

behaviourally.
• Organisational barriers involve individual nurse characteristics, organizational characteristics, the
nature of research information, and the healthcare environment.
• Facilitators of EPB: Important characteristics that the facilitator needs to possess are drive and a
positive enthusiastic approach, along with knowledge of the project, a certain level of hierarchy to
give the person credibility in the eyes of the medical staff, a manager of others, and good
communication skills.
ROGER’S DIFFUSION OF INNOVATION

• Diffusion is a social process that involves interpersonal communication and relationships. The 5
steps in the innovation decision process are:
• Knowledge, persuasion, decision, implementation, and confirmation.
IMPLEMENTATION

• The implementation of alcohol hand rub is to minimize nosocomial infection in hospital setting, for the safety of the nurses and   patient, and also
to minimize hospital acquired infection.
• Rogers' five stages (steps) are integral to this theory which includes:
• Awareness: it is imperative to practice frequent hand hygiene using the traditional soap and water or an alcohol-based hand rub as appropriate.  

• Interest/ persuasion: Frequent hand washing with soap and water or use of ethyl alcohol as a hand disinfectant usually make the skin rough and
dry. However, an alcohol based hand rub contains an emollient which helps keep the skin moist and soft. Thus, the introduction of alcohol based
hand rubs will be an important step in such settings to promote hand hygiene.
• Evaluation: This innovation in health care facilities will have more advantages in terms of improved safety among health care workers.

• Trial: implementation of alcohol based hand rubs would require organizations to educate staffs

• Adoption: The World Health Organization (WHO) has recommended alcohol based hand rub (ABHR) as the most effective tool to maintain hand
hygiene.
LITERATURE REVIEW

• This literature review was conducted to answer whether rinse-free hand sanitizer
programmes in the community can be expected to be not only effective, but save and
feasible outside controlled trails.
• Inclusion and Exclusion Criteria
• Selection Criteria and Methods One reviewer screened citations and selected studies.
In the first level of screening, titles and abstracts were reviewed and potentially
relevant articles were retrieved and assessed for inclusion.
EVALUATION PLAN
• A reference treatment is recommended to ensure internal validity. The test product must reduce the
resident flora by at least 1 log from baseline after the first application and by at least 2 log after the
second application.
• Evaluating Outcome Measures
• procedure for the recovery of surviving bacteria from the hands of volunteers after product application.
• Implication for practice and future research
• Further studies are essential to determine the relative efficacy of alcohol-based rinses and gels in
reducing transmission of health-care--associated pathogens.
CONCLUSIONS AND IMPLICATIONS FOR
DECISION
• In all studies, low to moderate quality evidence from two non-randomized studies
suggested that a guanidine-based rub and a chlorhexidine gel have antibacterial
activity against flora found on the hands of healthcare workers and volunteers.
The effectiveness of different formulations of these chemicals and the impact of
these products on infection and infection transmission rates are unknown.
• Further studies are essential to determine the relative efficacy of alcohol-based rinses and gels in
reducing transmission of health-care--associated pathogens.