Because Caregivers may wash their hands from a limited number of times per shift to as many as 30 times per shift, the
tendency of products to cause skin irritation and dryness is a substantial factor that influences acceptance and ultimate
usage. For example, concern regarding the drying effects of alcohol is a primary cause of poor acceptance of alcohol-based hand-hygiene products.
When choosing hand-hygiene products for potential use, consider factors that can affect the overall efficacy, including the antiseptic agents against various pathogens and practicality for use by Caregivers. Soap products are not well-accepted by Caregivers and can be a deterrent to frequent handwashing. Look for characteristics of an alcohol-based rub such as its smell, consistency, color, time required for drying and if it has emollients. For soaps, look for ease of lathering.
For frequent handwashing or antiseptic handwashing, keep hand-hygiene products accessible in the bathroom, kitchen and bedroom areas. One idea, in contrast to sinks used for handwashing or antiseptic hand wash, are dispensers for alcohol-based hand rubs that do not require plunging and can be made available adjacent to the Care Recipients' bed and other locations in care areas.
Also, a pocket carriage of alcohol-based hand-rub solutions, combined with dispensers will help with substantial improvement in reducing the spread of germs and infections.
Washing hands with soap and water after each use of an alcohol hand rub is not necessary and is not recommended, because it may lead to dermatitis. However, if you feel a “build-up” of emollients on your hands after repeated use of alcohol hand gels, washing hands with soap and water after 5–10 applications of a gel has been recommended by certain manufacturers.
Skin irritation by hand-hygiene agents constitutes a substantial barrier to appropriate adherence to handwashing. Because soaps and detergents can damage skin when applied on a regular basis, Caregivers must be better informed regarding the possible adverse effects associated with hand-hygiene agents. Alcohol-based hand rubs containing emollients (either isopropanol, ethanol, or n-propanol in 60%–90% vol/vol) were less irritating to the skin than soaps or detergents. In addition, alcohol-based products containing emollients are at least tolerable and efficacious as the detergents tested.
There are several hand lotions available to reduce skin scaling and cracking, which may reduce microbial shedding from the hands.
Boyce, J.M, & Pittet, D. M.D. (2002). Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force (Vol. 51/No. RR-16). Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, GA 30333.
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