Using Hand Sanitizers - Is a squirt and go method enough?

Nurses General Nursing

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We've all been taught the importance of washing our hands since we were kids. And when we got to nursing school, the importance was stressed even more. I don't know about you, but antibacterial soap and water is all we had when I hit the floor as a brand new nurse. Heck....we didn't even use gloves unless we were doing "sterile procedures", which did not include the handling of bodily fluids.

Now, we have even more options for protecting ourselves and others from those nasty germs that are waiting to infect us. One almost feels naked these days without donning gloves as well as appropriate PPE.

In spite of all the various types of PPE, we can all pretty much agree that frequent use of appropriate hand hygiene is the basis of protecting everyone involved.....whether or not they work in healthcare.

There has been debate over the years about the effectiveness of hand washing vs. sanitizers when it comes to infection control in hospitals and other healthcare settings. Studies conducted by the National Center for Biotechnology Information (NCBI) found that health care workers follow hand washing guidelines as set forth by the CDC only about 40 % of the time. It is common sense that sanitizers are more convenient for the healthcare team, and thus would help in increasing compliance. But do we know how to use hand sanitizers effectively? How long must we rub our hands together for the gel to do their deed of sanitizing? Is a squirt and go method enough?

Research presented June 18, 2016 at ASM Microbe 2016 (a meeting for the American Society for Microbiology and the Interscience Conference on Antimicrobial Agents and Chemotherapy) recommended that in order to kill bacteria, you need to rub for at least 15 to 30 seconds. There is no gain in effectiveness for rubbing longer than 30 seconds.

How many of your workplaces have a policy for hand hygiene?

Are there any punitive actions taken if you don't comply?

To read more about how the study was conducted, please read Hand Hygiene with Alcohol-Based Handrub: How Long is Long Enough?

For more allnurses articles about hand hygiene, go to:

Hand washing vs. Sanitizer, What are the Facts

Hand Hygiene Saves Lives, But Is It Realistic For All Nurses ...

Specializes in ICU.

We have policies for certain things we have to wash for. Like, physically wash our hands. For the most part, it's foam in and out though. I hate that honestly. The alcohol foam leaves a film on my hands so I honestly wash after 3-4 foams.

I feel gross with that film on my hands. We do have to scrub for at least 15 seconds on hands.

Missie Hannie

43 Posts

Specializes in NICU.

My hospital has a hand hygiene policy, and employees are made to watch mandatory training videos about once a year regarding proper hand hygiene. For the most part everyone uses the hand sanitizer dispensers located outside each patient room, with actual soap-and-water hand washing occurring after certain procedures, or when the feeling of dried sanitizer on your hands becomes too icky to tolerate.

Personally, I like the convenience of hand sanitizer, but I don't think that it is as effective as soap-and-water hand washing. When in doubt, I just wash my hands at the sink and skip the sanitizer altogether.

Specializes in Geriatrics, Trach Care, Diabetes.

I agree I like to wash my hands and Often! I rarely use sanitizer because I think it breeds super germs like the over use of anti-biotics. But yes, we sometimes don't have a choice and have to resort to sanitizer. Before I was a nurse I was a waitress/restaurant manager for 17 years. I was always appalled at the lack of hand washing I witnessed. I kid you not, won't mention the restaurant, but on Sunday we had 17+ servers and one hand washing sink. I NEVER had to wait in line!! EWE!

I wash so often, I developed these little bumps on my hands and I just mentioned it to my doctor at a routine visit and he said, yep you have healthcare hands from washing them so often. I took it as a compliment. My biggest gripe is the water in certain parts of the facility that I work in never seems to get warm enough for proper hand washing. I just do it twice under those circumstances:)

This is an interesting article about sanitizers and hand-washing. Sounds like antibacterial soaps containing tricolsan contribute to antibiotic resistance more than alcohol-based hand sanitizers.

Hand Sanitizer Doesn't Create Superbugs - Business Insider

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.

My facility has secret auditors who watch how well we're sanitizing (we have to wash/sanitize in and out of each patient's room).

We also have a requirement for washing-only for C-diff patients. The sanitizer dispensers are taped off in a patient's room when the patient has C-diff, so you have to wash with soap and water before leaving the room.

amzyRN

1,142 Posts

Specializes in ED, Cardiac-step down, tele, med surg.

I caught a really nasty stomach flu from a patient and I am very good at hand hygiene. For some things, I think soap and water is best. Any nausea or vomiting case for me gets a thorough wash with soap and water.

Buyer beware, BSN

1,139 Posts

Specializes in GENERAL.

Oh no, a squirt and go will not do. You are to wash your hands thoroughly, long enough to recite the "Happy Bithday"song to yourself. You then must dry you hands thoroughly humming "Hail ToThe Chief." Then you must expose them to ultra violet light for 30 seconds. And finally, and this is the most important part, place both hands in an autoclave for the prescribed amont of time.

To ensure complete sterility, I would send off a c+s w/ gram stain and then take off a day until results come back to be absolutely sure it's OK to resume patient care. Be sure to spend lots of time documenting all these steps because, as you know, if it isn't documented it wasn't done.

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Lunah, MSN, RN

14 Articles; 13,766 Posts

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
The alcohol foam leaves a film on my hands so I honestly wash after 3-4 foams.

THIS! I hate the way my hands feel, and when I do a soap/water wash, my palms feel slimy from the build-up. I prefer soap and water when I can (and as required with certain patients), gel/foam when I'm in a hurry.

Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
The alcohol foam leaves a film on my hands so I honestly wash after 3-4 foams.

I almost wonder if that isn't something designed into the product on purpose... after a few times it makes your hands feel icky, so you wash them with soap and water regularly to get the ickiness off.

Buyer beware, BSN

1,139 Posts

Specializes in GENERAL.
Oh no, a squirt and go will not do. You are to wash your hands thoroughly, long enough to recite the "Happy Bithday"song to yourself. You then must dry you hands thoroughly humming "Hail ToThe Chief." Then you must expose them to ultra violet light for 30 seconds. And finally, and this is the most important part, place both hands in an autoclave for the prescribed amont of time.

To ensure complete sterility, I would send off a c+s w/ gram stain and then take off a day until results come back to be absolutely sure it's OK to resume patient care. Be sure to spend lots of time documenting all these steps because, as you know, if it isn't documented it wasn't done.

Addendum/Update: Just out from the CDC. The above recommendation to hum "Hail to the Chief" while drying your hands has been modified to just whistling "Dixie."

smartassmommy

324 Posts

Addendum/Update: Just out from the CDC. The above recommendation to hum "Hail to the Chief" while drying your hands has been modified to just whistling "Dixie."

Crap, I can't whistle.:roflmao:

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