Alcohol hand rubs not enough to curb hospital infections

[flashl]

A study finds the impact of these products minimal, most likely because gels need to be accompanied by other control strategies.

Making alcohol-based hand gels common and accessible in hospitals increases their use and cuts the amount of microbes on the hands of nursing staff. But it does not cut the rates of device-associated infections, illness caused by drug-resistant bacteria or cases of Clostridium difficile, says a study published in the January Infection Control & Hospital Epidemiology.

...

"People get the message just clean your hands, all the infections will go away. hand hygiene is not a panacea, and there's not a simple single fix for everything," said Mark E. Rupp, MD, lead author and professor of infectious diseases at the University of Nebraska Medical Center in Omaha.

Researchers did the study in two intensive care units at the medical center over two years. Alcohol-based hand rub and education about its use were provided in one unit the first year and not the other. The second year, the units were flipped. Although the hand hygiene rate nearly doubled where the intervention occurred, no change in the hospital-acquired infection rate was detected. Several theories offer reasons why this intervention did not have the desired effect.

"This is not a strike against the importance of hand hygiene in health care settings," said Gonzalo Bearman, MD, MPH, assistant professor of medicine and associate hospital epidemiologist at Virginia Commonwealth University Medical College in Richmond. "These alcohol hand rubs decreased microbial burden on their hands, and that's really important."

American Medical News

[Celebration]

1. time to use aromatherapy oils

http://www.manchestereveningnews.co.uk/news/s/1001/1001223_scent_could_snuff_out_hospital_bugs.html

[Historic NY]

2. They also need to do better housekeeping..........

pushing the dirt around the rooms isn't helpfully either. I've been to a local hospital that had so much dirt under the radiator that never moved. I was in the same room 3 times. I finally asked them when do they actually clean the room. I always though the rooms were supposed to be completely clean. The hospital lobby is probably cleaner. What lurks in the rooms is probably just as bad as the filth on ones hands.

[Warpy]

3. This is a direct result of housekeeping staff being cut to the bone

I had a lot of long conversations with our housekeeping staff at the last hospital. Supervisors who had teams under them found themselves solely responsible for the work, no team to help, due to personnel cuts to save money. The work that had been done by five people was dumped onto the shoulders of one person. Housekeeping staff was about ready to crack and a lot of stuff was getting half done or skipped.

Hospitals are desperate to cut costs and staff feels the pinch first. Cutting housekeeping means that rooms and equipment aren't nearly as clean and cleaned as often and thoroughly as they should be. I saw phenomena like the "cursed bed" where successive patients would develop infections. I realized what the problem was and clued the housekeeping staff into the need for a complete cleaning and the problem would be solved, but not before people suffered needless infection due to staff cuts leading to poor cleaning.

One ICU saw a C-diff epidemic. It was traced to a digital thermometer. The probe covers were disposable, but the bugs were leaping from the unit itself to the patient in the bed, probably through the tech's hands on the unit and transferred to the cover. The unit hadn't been completely cleaned between each use due to time constraints due to staff cuts.

The LAST way a hospital should cut costs is in staffing. The best predictor of a positive patient outcome is the amount of contact with an RN. Meticulous housekeeping should also be factored into that.