Hand hygiene is the key measure of basic hygiene, yet compliance is still undervalued by healthcare workers. A fundamental finding is that hand disinfectant’s skin tolerability, and employees’ skin health, are two important prerequisites for encouraging healthcare workers to perform hand disinfection.
Approximately 5 million people in Europe and around 1.7 million people in the US acquire an infection during nursing or medical treatment each year. Importantly, these figures relate to new infections, unrelated to the patient’s initial reason for admission.
Infections acquired in hospitals and outpatient facilities (known collectively as healthcare-associated infections or HAI) are one of the greatest threats to patient safety across the world.
HAI affects patients and healthcare workers and has a knock-on effect on health economics. Patients may face emotional stress, prolonged hospital stays, long-term disability, increased resistance of microorganisms to antimicrobials and/or additional financial burdens while infections transmitted to healthcare workers risk could lead to sickness and absence. The longer an infected patient is in the facility, the higher the costs. There is also the risk of increased mortality figures.
In developed countries, HAI affects 5–15% of hospitalised patients and as many as 9–37% of those admitted to intensive care units (ICUs).
Despite the risk, the World Health Organisation’s Guidelines on Hand Hygiene in Health Care shows that recommended hand hygiene procedures are still not being consistently adhered to.
Hand disinfection is the key preventive measure
According to experts, a third of HAI could be prevented with systematic hygiene and surveillance measures, with the most important individual measure being hygienic hand disinfection.
Hand disinfection is an essential element in avoiding HAI and, consequently maintaining patient safety. While it’s one of the easiest measures to implement, compliance could still be improved.
Healthcare workers quite often underestimate the importance of hand disinfection. Hand to hand germ transfer is prevalent in environments where many people share limited space. For example, in care homes, pathogenic microorganisms can be found throughout the building on a wide range of objects. Targeted hand disinfection is therefore crucial, not only for preventing germ transfer and protecting patients from infections, but also for safeguarding staff. After all, employee safety is patient safety.
The importance of skin-friendliness
Due to their strong antimicrobial activity, rapid action, good skin tolerability and ease of use, alcohol-based hand rubs are recommended for hand disinfection. However, effective hand hygiene is dependent on skin being intact. This is a particular issue for caregivers given the number of skin-stressing influences they are exposed to every day, including repeated hand washing.
One of the most common occupational diseases among health care workers is irritant contact dermatitis, an inflammatory skin disease in which skin becomes dry and rough in its early stage. To minimise occurrence, skin care and skin protection is important.
For hand rubs to be effective, it is essential to keep skin healthy, as even the smallest cracks and micro traumas can lead to a burning sensation when using hand disinfectants. This can compromise their proper application.
As well as communicatingthe five key moments when hand disinfection should be performed, there are two fundamental messages that need to be communicated to encourage compliance - the hand disinfectant’s skin tolerability and the efficacy of the disinfection.
In terms of skin tolerability, there are often concerns that frequent hand disinfection with alcohol-based products might dry the skin or disturb the skin barrier. In fact numerous studies have proven that alcohol-based hand disinfection is better tolerated than hand washing. Recently it has been shown that the alcohol-based hand rub Sterillium classic pure can even help to hydrate the skin and maintain the skin’s elasticity.
As well as offering reliable efficacy, hand disinfectants need to be skin friendly or even exhibit skin caring effects e.g. by moisturising the skin. As well as improving hygiene, frequent use of skin-friendly hand disinfectants – particularly those with skin caring properties - can, to some extent, compensate for dry skin caused by frequent hand washing. Using these products several times a day, during working hours, increases staff and patient protection at the same time.