Use hand sanitizer sign pdf2/7/2024 Other hand hygiene policies and products were standardized across both study units. Hand lotion (Soft Skin Conditioner Steris Corporation) was provided throughout the study in both NICUs. During the ALC phase, a nonantimicrobial liquid soap (Kindest Kare Body Wash and Shampoo Steris Corporation) was also provided for use when hands were physically soiled. The 2 tested hand hygiene products were traditional handwashing with an antiseptic detergent containing 2% chlorhexidine gluconate (CHG) (Bactoshield Steris Corporation, St Louis, Mo) or a hand sanitizer containing 61% ethanol and emollients (ALC) (3M Avagard D Instant Antiseptic Hand Sanitizer with Moisturizers 3M HealthCare, St Paul, Minn). Nurses were studied because they touched the neonates most often 3 and were the largest group of health care professionals permanently assigned to the study units. Part-time and agency nurses and nurses from other units who occasionally worked in the NICU were not eligible. 2Īll neonates hospitalized for more than 24 hours on the study units were eligible for inclusion in the study, and all full-time nurses were eligible to participate. While this was a sample of convenience, the study units were similar to the NICUs in the National Nosocomial Infections Surveillance (NNIS) system database in terms of types and rates of infections and distribution of birth weights. The 2 units were about 6 miles apart with the only shared staff being 2 neonatal fellows each year. During the study period, NICU 1 had approximately half the square footage per neonate when compared with NICU 2. Each unit comprised 4 to 6 rooms housing 6 to 10 isolettes. The study was conducted in 2 NICUs in Manhattan that are part of the New York Presbyterian Hospital: a 43-bed unit (NICU 1) and a 50-bed unit (NICU 2). Other practices such as frequency and quality of hand hygiene are likely to be as important as product in reducing risk of cross-transmission. However, assessing the impact on infection rates of a single intervention is challenging because of multiple contributory factors such as patient risk, unit design, and staff behavior. The skin condition of participating nurses was significantly improved during the alcohol phase ( P = .02 and P = .049 for observer and self-assessments, respectively), but there were no significant differences in mean microbial counts on nurses’ hands (3.21 and 3.11 log 10 colony-forming units for handwashing and alcohol, respectively P = .38).Ĭonclusions Infection rates and microbial counts on nurses’ hands were equivalent during handwashing and alcohol phases, and nurses’ skin condition was improved using alcohol. Results After adjusting for study site, birth weight, surgery, and follow-up time, there were no significant differences in neonatal infections between the 2 products odds ratios for alcohol compared with handwashing were 0.98 (95% confidence interval, 0.77-1.25) for any infection, 0.99 (95% CI, 0.77-1.33) for bloodstream infections, 1.61 (95% CI, 0.57-5.54) for pneumonia, 1.78 (95% CI, 0.94-3.37) for skin and soft tissue infections, and 1.26 (95% CI, 0.42-3.76) for central nervous system infections. Each product was used for 11 consecutive months in each neonatal intensive care unit in random order. Intervention Two hand hygiene products were tested: a traditional antiseptic handwash and an alcohol hand sanitizer. Objective To compare the effect of 2 hand hygiene regimens on infection rates and skin condition and microbial counts of nurses’ hands in neonatal intensive care units.ĭesign, Setting, and Participants Clinical trial using a crossover design in 2 neonatal intensive care units in Manhattan, NY, from March 1, 2001, to January 31, 2003, including 2932 neonatal hospital admissions (51 760 patient days) and 119 nurse participants.
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