title: Introduction of a waterless alcohol-based hand rub in a long-term-care facility.
abstract: OBJECTIVE
  To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).
  
  
  METHODS
  Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique for Staphylococcus aureus, gram-negative bacilli (GNB), Candida, and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.
  
  
  RESULTS
  Hand hygiene practices, knowledge, and opinions did not change after the educational or rub intervention. Ward A HCWs thought that the rub was faster (P = .002) and less drying (P = .04) than soap. Hand hygiene frequency did not differ at baseline between the two floors, but increased on ward A by the end of the study (P = .04). HCWs were colonized frequently with GNB (66%), Candida (41%), S. aureus (20%), and VRE (9%). Although colonization did not change from baseline on either ward, the rub was more effective in clearing GNB P =.03) and S. aureus (P = .003). Nosocomial infection rates did not change.
  
  
  CONCLUSIONS
  The alcohol-based hand rub was a faster, more convenient, less drying method of hand hygiene for HCWs in an LTCF, and it improved compliance. Although microbial colonization did not change, the rub was more efficacious in removing pathogens already present on the hands of HCWs.
authors.affiliation: Division of Geriatric Medicine, Veterans Affairs Ann Arbor Healthcare System, University of Michigan Medical School, Ann Arbor, Michigan 48105, USA.
authors.forename: Lona
authors.initials: L
authors.lastname: Mody
authors.forename: Shelly A
authors.initials: SA
authors.lastname: McNeil
authors.forename: Rongjun
authors.initials: R
authors.lastname: Sun
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Bradley
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology*; D002175:Candida / Q000302:isolation & purification; D016983:Enterococcus / Q000302:isolation & purification; D000431:Ethanol / Q000008:administration & dosage / Q000494:pharmacology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006225:Hand / Q000382:microbiology; D006235:Hand Disinfection / Q000379:methods* / Q000592:standards*; D006801:Humans; D006920:Hygiene; D009735:Nursing Homes; D009740:Nursing Staff; D013211:Staphylococcus aureus / Q000302:isolation & purification
chemical_list: D000891:Anti-Infective Agents, Local; D000431:Ethanol