title: Hand hygiene compliance in the critical care setting: a comparative study of 2 different alcohol handrub formulations.
abstract: BACKGROUND
  Hand hygiene (HH) compliance can be affected by the accessibility of products (alcohol-based products or chlorhexidine) and by the formulations of these products. There are few published studies comparing different alcohol-based hand disinfection formulations.
  
  
  METHODS
  This study was conducted in a 41-bed medical-surgical intensive care unit at a private tertiary care hospital. Over a 16-week period, we assessed HH compliance by direct observation of practice using iPods and measurement of the amount of product used [alcohol and chlorhexidine] in two 4-room pods in which an alcohol gel product was used compared with two other 4-room pods in which an alcohol-based foam formulation was used.
  
  
  RESULTS
  A total of 3,895 opportunities for HH were observed, and the overall rate of HH compliance was 36.9%. No statistically significant differences were found in overall HH compliance or alcohol-based HH compliance between the alcohol foam unit and the alcohol gel unit. However, there was a statistically significant difference in chlorhexidine HH compliance between the alcohol foam unit and the alcohol gel unit (7.0% [130 of 1,853] vs 3.8% [77 of 2,042]; P < .01).
  
  
  CONCLUSIONS
  Alcohol handrub use was greater than chlorhexidine use, but HH compliance was low in both units independent of the alcohol formulation available. The similarity of use of both alcohol formulations suggests that health care workers tend to use whatever product is readily available.
authors: Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil. alexmarra@einstein.br
authors: Alexandre R
authors: AR
authors: Marra
authors: Thiago Zinsly S
authors: TZ
authors: Camargo
authors: Vanessa Jonas
authors: VJ
authors: Cardoso
authors: Denis Faria
authors: DF
authors: Moura
authors: Emerson
authors: E
authors: Casemiro de Andrade
authors: Juliana
authors: J
authors: Wentzcovitch
authors: Alex Sandro
authors: AS
authors: Santos da Rocha
authors: Oscar Fernando
authors: OF
authors: Pavão dos Santos
authors: Michael B
authors: MB
authors: Edmond
mesh_terms: D000438:Alcohols / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage; D003428:Cross Infection / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006235:Hand Disinfection / Q000379:methods*; D007362:Intensive Care Units; D062606:Tertiary Care Centers
chemical_list: D000438:Alcohols; D004202:Disinfectants; D002710:Chlorhexidine