Alcohol hand rubs not enough to curb hospital infections

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

By Victoria Stagg Elliott, AMNews staff. Feb. 25, 2008.

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.

Authors and other experts say this situation is not because the products are ineffective. Rather, increases in their use need to be carried out in conjunction with other infection control strategies.

"People get the message [that if you] just clean your hands, all the infections will go away. [But] 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.