Since the creation of alcohol-based hand sanitizer, hand hygiene compliance has increased. Hand sanitizer dispensers can be found almost anywhere – in the grocery store, in doctors’ offices, and around just about every corner in the hospitals. These dispensers have made hand hygiene before and after patient use much more effortless and accommodating. The article by Maliekal et al. declares that hand sanitizer is “far more efficient in reducing transient bacterial flora [and] is more convenient and time saving.” Additionally, the journal article states that “it is recommended as a hand hygiene practice in critical areas” (Maliekal et al.). The article leads the audience to believe that alcohol-based hand sanitizers are far better than the traditional hand-washing. The results of their study concluded that hand sanitizer reduced the transient bacterial flora in 95% of the samples as compared to the 50% of cases where hand-washing with soap and water was used. The health care workers that were sampled made specimens that contains Escherichia coli, Klebsiella spp., nonlactose fermenting Gram-negative bacilli, staphylococci, and streptococci (Maliekal et al.).
However, the audience should take caution when reading this article. The experimented only studied a narrow range of bacteria, compared to the multitude of bacteria that exist in the world, specifically in the health care setting. The quantity, quality, and consistency of this experiment is lacking. Furthermore, only 34 nurses were used to create a total of 204 samples (Maliekal et al.). The article assumes that based on these few samples, alcohol-based hand rubs are far superior to hand-washing when killing bacteria. Additionally, the article assumes that the only bacteria in the hospital setting, specifically the ICU, are those that were outlined in the study. However, this is just not the case. Additional experiments would need to be completed on a variety of different bacterial and viral agents.
Nurses see multiple different patients each day with varying illnesses and diseases. If these nurses do not practice effective hand-hygiene before and after each patient encounter, bacteria and viruses can be spread and thus infect the other patients and even the nurses themselves. Not only do nurses not practice hand hygiene before and after each patient use, nurses do not wash their hands with soap and water enough throughout the day, especially in light of this article. Hand sanitizer is not always superior to hand washing, specifically when protecting against Clostridium difficile and the norovirus (System change - changing hand hygiene behaviour at the point of care). There are times when hand sanitizer is just not enough (When to Use Hand Sanitizer). The community should not replace hand-washing with hand-sanitizer.
This study is applicable to many areas of healthcare, considering bacterial and viral agents are present everywhere and nurses should use hand hygiene before and after every patient interaction. However, changes need to be made to this study to make it more credible and useful to the medical community. More samples and more organisms would need to be utilized to make the study more credible to the healthcare community. Furthermore, the article needs to address its limitations in the study to provide more credibility to its experiment.
References
Maliekal, M., Chitnis, D., Hemvani, N., Ukande, U., Geed, S., Bhattacherjee, M., & George, J.
(2005). Comparison of traditional hand wash with alcoholic hand rub in ICU setup. Indian Journal of Critical Care Medicine Indian J Crit Care Med, 9(3), 141. Retrieved February 21, 2016.
System change - changing hand hygiene behaviour at the point of care. (n.d.). Retrieved
When to Use Hand Sanitizer. (2015, July 22). Retrieved February 21, 2016, from
http://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html
