title: Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital.
abstract: We determined risk factors for hand contamination and compared the efficacy of 3 randomly allocated hand hygiene agents in a group of surgical intensive care unit nurses. We cultured samples of one of the subjects' hands before and samples of the other hand after hand hygiene was performed. Ring wearing was associated with 10-fold higher median skin organism counts; contamination with Staphylococcus aureus, gram-negative bacilli, or Candida species; and a stepwise increased risk of contamination with any transient organism as the number of rings worn increased (odds ratio [OR] for 1 ring worn, 2.6; OR for >1 ring worn, 4.6). Compared with use of plain soap and water, hand contamination with any transient organism was significantly less likely after use of an alcohol-based hand rub (OR, 0.3; 95% confidence interval [CI], 0.1-0.8) but not after use of a medicated hand wipe (OR, 0.9; 95% CI, 0.5-1.6). Ring wearing increased the frequency of hand contamination with potential nosocomial pathogens. Use of an alcohol-based hand rub resulted in significantly less frequent hand contamination.
authors.affiliation: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. wbt9@cdc.gov
authors.forename: William E
authors.initials: WE
authors.lastname: Trick
authors.forename: Michael O
authors.initials: MO
authors.lastname: Vernon
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hayes
authors.forename: Catherine
authors.initials: C
authors.lastname: Nathan
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Rice
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Peterson
authors.forename: John
authors.initials: J
authors.lastname: Segreti
authors.forename: Sharon F
authors.initials: SF
authors.lastname: Welbel
authors.forename: Steven L
authors.initials: SL
authors.lastname: Solomon
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D000438:Alcohols / Q000494:pharmacology; D003428:Cross Infection / Q000209:etiology; D004202:Disinfectants / Q000494:pharmacology*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006225:Hand / Q000382:microbiology*; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D006920:Hygiene; D017053:Infection Control; D007362:Intensive Care Units; D012307:Risk Factors; D012915:Soaps / Q000494:pharmacology
chemical_list: D000438:Alcohols; D004202:Disinfectants; D012915:Soaps