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International Journal for Quality in Health Care Advance Access originally published online on March 15, 2006
International Journal for Quality in Health Care 2006 18(2):120-122; doi:10.1093/intqhc/mzi109
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International Journal for Quality in Health Care vol. 18 no. 2 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved

Review Article

One plunge or two?—hand disinfection with alcohol gel

Duncan J. M. Macdonald1, Elisabeth C. A. Mckillop2, Sylvia Trotter1 and Alastair J. R. Gray1

1 Department of Orthopaedic Surgery, Western Infirmary, and 2 Gartnavel General Hospital, Tennents Institute of Ophthalmolgy, Glasgow, UK

Objective. To compare health care workers’ hand surface coverage using two different volumes of alcohol gel for hand disinfection.

Participants and methods. A total of 84 members of staff in our hospital were studied. Subjects were asked to disinfect their hands with alcohol gel containing a clear fluorescent substance. Performance was assessed by using UV light to identify areas which had been missed, and the total surface area missed was calculated. A total of 42 subjects received 3.5 ml of alcohol gel, and 42 age-, sex-, and job-matched subjects received 1.75 ml of alcohol gel.

Results. Significantly less area was missed when hand disinfecting with double the volume of alcohol gel; 1.23 versus 6.35% surface area was missed (P < 0.001).

Conclusion. Doubling the volume of alcohol gel used for hand disinfection significantly improves the efficiency of coverage of the hands with alcohol gel. This may result in lower bacterial count on the hands and may reduce the spread of nosocomial infections including that of methicillin-resistant Staphylococcus aureus.

Keywords: infection control, hospital infection, hand washing

Address reprint requests to Duncan J. M. Macdonald, Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK. E-mail: djmmacd{at}hotmail.com

Accepted for publication November 10, 2005.


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