NRS328: Evaluating Alcohol Based Hand Rub Effectiveness Review

This literature review explores the effectiveness of alcohol-based hand rubs in healthcare settings, comparing them to traditional soap and water methods for hand hygiene. It examines various studies and articles, including those focusing on the removal of Clostridium difficile spores. While alcohol-based hand rubs are widely used due to their convenience, the review suggests that soap and water remain more effective in certain situations. The review also highlights the importance of hand hygiene in reducing healthcare-associated infections and emphasizes the need for further research to develop more effective hand sanitizing solutions. Desklib offers a platform to access this document along with numerous other solved assignments and study resources.

Running head: EFFECTIVENESS OF ALCOHOL BASED HAND RUB
EFFECTIVENESS OF ALCOHOL BASED HAND RUB
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1EFFECTIVENESS OF ALCOHOL BASED HAND RUB
EFFECTIVENESS OF ALCOHOL BASED HAND RUB
Key words: alcohol based hand rub, hand hygiene, hand washing, healthcare
Abstract:
Hand hygiene is one of the greatest awareness that is trying to prevent infections
spreading through contaminated hands since spread of micro-bacteria are easily transferred
through polluted hands. To reduce the process of spreading infectious pathogens hand wash is
repeatedly advised by the health expert to health workers, patients other people as a measure of
precautions. Although hand hygiene have become a concern there is still doubt about the
methods of cleaning hands. It has been observed that the traditional method of washing hands is
slowly been replaced by the alcohol based hand rubs. The present study is conducted to find out
the effectiveness of the alcohol based hand rubs compared to the soap and water method. The
methods adapted for carrying this study knowledge from library and peer reviewed articles
available online such as Google Scholar, CINAHL and PubMed. At the end of the research the
finding tells why the use of alcohol based hand rubs is preferred over the soaps and water.
Analyzing the finding it can be stated that more measures can be discovered for the safety
purpose and for the cleanliness of hands.
Introduction
A literature review is an in-depth process of reviewing article, book and journals that
helps in gathering knowledge about a certain subject matter. Literature has a significance role in
conducting empirical researches that includes present knowledge and theoretical as well as
methodological contribution from peer scholars on a specific topic (Hamari, Koivisto, & Sarsa,
2014). The present literature review is on how an alcohol based hand rub is effective in the

2EFFECTIVENESS OF ALCOHOL BASED HAND RUB
healthcare. An important measure of reducing infections through transmission among the health
worker is using of medical solutions for hand hygiene (Maher, Eslami & Ali-Mohammadzadeh,
2016). The use of hand rubs in the healthcare areas has been an important measure (Boyce et al.,
2017). Washing hands with water and soap is surely the best method of removing germs and
microbes however, it is not always easily available in the surrounding. The paper highlights the
effectiveness of the alcohol based hand rubs and the ways it can be used in the healthcare for the
patients.
Aims and objectives:
This paper focused on the effectiveness of alcohol based hand rubs. The paper also
provides knowledge about the alcohol based hands rub is and the advantages of using the alcohol
based hand rubs.
The main objectives of the study are-
 To indentify the effectiveness of alcohol based hand rub.
 To understand the using the alcohol based hand rubs over soap and water.
Methods:
The present study includes knowledge obtained from library and classrooms. Also, the source
of conducting the present study is the database obtained from Google Scholar and PubMed. The
study has also included CINAHL for obtaining database. The inclusion criteria for selecting the
articles are the articles published in English language only, published within the year of 2010 to
2018 and the articles that are found in full text format. The articles not fulfilling these three
criteria are the considered excluding factors.

3EFFECTIVENESS OF ALCOHOL BASED HAND RUB
Result:
Author/Date Journal Title Methodology
Kundrapu, S., Sunkesula,
V., Jury, I., Deshpande,
A., & Donskey, C. J
Infection Control
& Hospital
Epidemiology
A randomized trial of soap
and water hand wash
versus alcohol hand rub for
removal of Clostridium
difficile spores from hands
of patients
Quantitative
method
Jabbar, U., Leischner, J.,
Kasper, D., Gerber, R.,
Sambol, S. P., Parada, J.
P., ... & Gerding, D. N.
Infection Control
& Hospital
Epidemiology
Effectiveness of alcohol-
based hand rubs for
removal of Clostridium
difficile spores from hands
Quantitative
method
Yeung, W. K., Tam, W. S.
W., & Wong, T. W.
Infection Control
& Hospital
Epidemiology
Clustered Randomized
Controlled Trial of a Hand
Hygiene Intervention
Involving Pocket-Sized
Containers of Alcohol-
Based Hand Rub for the
Control of Infections in
Long-Term Care Facilities
Quantitative
method
The common thing between all the three articles is the significance that has been given to
hand washing. There has been increase in the awareness of hand hygiene however, there is also
very limited efforts in comparison to the magnitude of the problem. Hand hygiene is one of the
vital parts that are required to reduce transmission of healthcare associated microorganism.
Healthcare associated infections tend to get more attention from healthcare workers, patients and
regulatory bodies (Jabbar et al., 2010). The problem is not only popular for the diseases it can
cause or the cost of treatment one has to bear but also for the fact that it is easily preventable.
Therefore, hand hygiene is considered as one of the basic and yet significant element of infection
control activity. All the three articles have emphasized on the importance of hand hygiene
(Kundrapu et al., 2014). Effective hand hygiene proves to a beneficial method of substantially
decrease contaminated infections among the healthcare workers. Along with endemic infections

4EFFECTIVENESS OF ALCOHOL BASED HAND RUB
a healthy hand hygiene program is useful in decreasing the emergence of pathogens that are
antibiotic resistant (Yeung, Tam & Wong, 2011).
Various studies has been conducted on a trial of hand soaps with water, hand washes and
alcohol hand rubs which determines the product capacity of removing clostridium difficile spore
from patient’s hands. there are two studies that have conducted for same reason however they are
different in their perspective. Clostridium difficile has always been a major issue for hand
hygiene as the spores are found to be resistant to products that are alcohol based. The process of
hand washing with soap is more effecting when done by hand wash or the soaps and water. The
random trial done on a group of patients found that patient’s hands that were contaminated with
the clostridium difficile spores is benefitted by the soap and water washing (Kundrapu et al.,
2014). However, another study that was conducted for the same purpose shows that the usage of
alcohol based hand rubs is efficient in removing clostridium difficile. The study also says that
further studies are required to investigate therefore relying solely on the alcohol based hand rubs
is not adequate to decontaminate hands. The viable spores will have the potential of spreading to
the hands of the health workers as well or to other patients (Jabbar et al., 2010). Washing with
water and soaps physically rinse off the spore from the patient’s hands. The alcohol hand rub
failed reduce the burden of spores and the frequency of positive culture that was possible by
soaps and water. (Kundrapu et al., 2014). The alcohol based hand rubs can be used to
contaminate hands of the patients however relying solely on it is not advisable (Jabbar et al.,
2010).
Among all the articles only the article by Yeung, Tam & Wong reflects the reason why
alcohol based hand rub is preferred more than the soap and water. The healthy hand hygienic
program includes washing of hands with soaps and water, hand washes and the alcohol based

5EFFECTIVENESS OF ALCOHOL BASED HAND RUB
hand rubs. The alcohol based hand rubs are one of the most used method in the healthcare
workforce. The study was conducted to see the usage of pocket-sized container alcohol based
hand rubs among the elderly residents. The study finds the usage of the alcohol based hand rub
usage has the tendency to increase where the usage of soap and water has the tendency to slow
down. The process of washing hand is not preferred since the convenient method is to use the
pocket size container of the alcohol based hand rubs. The result shows that the use of alcohol
based hand rub is more efficient in bringing the healthy hand hygiene culture. The use of soaps
and water is reduced and replaced by the usage of the alcohol based hand rubs. The study needed
further investigation as well to find the effect of hand hygiene on self-limiting infections or
minor infections (Yeung, Tam & Wong, 2011).
Findings:
All the three articles have given insight about the effectiveness of alcohol based hand
rubs. According to the reviewed articles it can be stated that the alcohol based hand rubs are not
as much efficient as the water and soaps which have been the traditional practice of maintaining
the hygiene of hands. The articles explain that the patients and the workers are concerned about
the positive impact of the effective hand washing however the measure of performing the action
is guided by the convenience. The pocket-size alcohol based rub is easier to use and therefore it
is mostly chosen by the healthcare workers and the patients.
Relevance to Clinical Practice:
The finding tells that the better way of maintain the hygiene is the washing hand with
soaps and waters than the alcohol based hand rub (Halm & Sandau, 2018). The alcohol based
hand rubs are not incapable of removing the pathogens; it has proven to be efficient (Managan,

6EFFECTIVENESS OF ALCOHOL BASED HAND RUB
2015). The usage of alcohol based hand rubs can be continued as it does help in cleaning the
hands effectively however, having infections such as clostridium difficile and such infections
will require a healthier habit. The healthcare centre can proceed to use the alcohol based hand
rubs since the second study shows the process of washing hand decreases with the time when the
usage of the convenient method is used more often (Blenkharn & Smales, 2017). This process of
adapting alcohol based hand rub may require little extra investment for the healthcare however; it
will evolve the hand hygiene culture which will reduce the contaminated infections. There needs
to be further investigations on creating hand rubs that would be totally satisfactory and also soft
antibiotic towels for the emergency purposes in the medical for the healthcare workers.
Conclusion:
Effective hand washing ensures lesser contaminated environment therefore the hand
washing habit is frequently seen as one of the main element of healthy habit (Foddai, Grant &
Dean, 2016). The washing of hands with soaps and water is one of the best ways to eliminate the
chances infections caused by contaminating pathogens (Chraïti, & Widmer, 2017). However, the
alcohol based hand rubs has replaced the soaps and water method of cleansing hands and it is
now used widely. Reviewing the data of the peer scholars it s evident that usage of water and
soaps is the efficient way however, the alcohol based hand rubs are slightly lesser inefficient
compared to the soaps and water. Since the alcohol based hand rubs are convenient it is used
widely by the healthcare and the patients to ensure hand’s hygiene. Therefore, the alcohol based
hand rubs are effective to a great extend and since it is a convenient method it should continue
using it.

7EFFECTIVENESS OF ALCOHOL BASED HAND RUB
Reference:
Blenkharn, J. I., & Smales, C. (2017). Handwash product and handwash technique are equally
important. Journal of Hospital Infection, 96(3), 298-299.
Boyce, J. M., Polgreen, P. M., Monsalve, M., Macinga, D. R., & Arbogast, J. W. (2017).
Frequency of use of alcohol-based hand rubs by nurses: a systematic review. infection
control & hospital epidemiology, 38(2), 189-195.
Chraïti, M. N., & Widmer, A. F. (2017). Hand hygiene technique. Hand hygiene: a handbook for
medical professionals, 70-75.
Foddai, A. C., Grant, I. R., & Dean, M. (2016). Efficacy of instant hand sanitizers against
foodborne pathogens compared with hand washing with soap and water in food
preparation settings: a systematic review. Journal of food protection, 79(6), 1040-1054.
Halm, M., & Sandau, K. (2018). Skin Impact of Alcohol-Based Hand Rubs vs
Handwashing. American Journal of Critical Care, 27(4), 334-337.
Hamari, J., Koivisto, J., & Sarsa, H. (2014, January). Does gamification work?--a literature
review of empirical studies on gamification. In 2014 47th Hawaii international
conference on system sciences (HICSS) (pp. 3025-3034). IEEE.
Jabbar, U., Leischner, J., Kasper, D., Gerber, R., Sambol, S. P., Parada, J. P., ... & Gerding, D. N.
(2010). Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile
spores from hands. Infection Control & Hospital Epidemiology, 31(6), 565-570.

8EFFECTIVENESS OF ALCOHOL BASED HAND RUB
Maher, A., Eslami, Z., & Ali-Mohammadzadeh, K. (2016). Effect of Hand Hygiene Education
on Knowledge, Attitude and Practice of NICU and Pediatric Staff in Zanjan
Hospitals. Human Resource Management, 3(2), 35-43.
Managan, K. (2015). “One Hand Washes the Other”: Social Capital and the Politics of Leisure in
Guadeloupean Associations. French Politics, Culture & Society, 33(3), 74-94.
Kundrapu, S., Sunkesula, V., Jury, I., Deshpande, A., & Donskey, C. J. (2014). A randomized
trial of soap and water hand wash versus alcohol hand rub for removal of Clostridium
difficile spores from hands of patients. Infection Control & Hospital
Epidemiology, 35(2), 204-206.
Yeung, W. K., Tam, W. S. W., & Wong, T. W. (2011). Clustered randomized controlled trial of
a hand hygiene intervention involving pocket-sized containers of alcohol-based hand rub
for the control of infections in long-term care facilities. Infection Control & Hospital
Epidemiology, 32(1), 67-76.