title: Comparing hand hygiene measures in a neonatal ICU: a randomized crossover trial.
abstract: OBJECTIVE
  To compare plain soap, alcohol hand rub and iodophors as hand hygiene measures in a neonatal intensive care unit (NICU).
  
  
  METHODS
  Randomized, crossover, three-armed, controlled trial with blinded outcome measurement.
  
  
  METHODS
  Level III NICU.
  
  
  METHODS
  35 NICU nurses.
  
  
  METHODS
  Participants were assigned to plain soap hand washing, alcohol hand rub and povidone-iodine hand scrub by a random cross-over design. Interventions were preceded by 14-day neutral periods. Cultures from hands were taken before and after each hand-hygiene use, prior to 5 patient-care activities.
  
  
  METHODS
  The primary outcome was mean post-hygiene colony forming unit count (CFU-C).
  
  
  RESULTS
  There were differences between soap, alcohol and povidone groups vis a vis posthygiene CFUC [median: 60, 8 and 10.5, respectively (P<0.001)], absolute reduction in CFU-C [median: 15, 100 and 40, respectively (P<0.001)], percent reduction in CFUC [median: 33.3, 92 and 87, respectively (P<0.001)] and proportion with low CFU-C [47%, 71% and 72%, respectively (P<0.001)]. Alcohol [Adjusted OR 3.2 (95% CI 1.9, 5.3)], povidone-iodine [AOR 3.1 (95% CI 1.8, 5.3)] and high prehygiene CFU-C (>300) [AOR 0.18 (95% CI 0.1, 0.3)] were independently associated with low CFU-C.
  
  
  CONCLUSIONS
  After a 2 minute hand wash at entry into NICU, alcohol hand rub and povidone-iodine scrub are superior to plain soap hand wash for subsequent decontamination of hands of nurses working in NICU.
authors.affiliation: Departments of Pediatrics and *Microbiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160 012, India. Correspondence to: Dr Sourabh Dutta, Additional Professor, Division of Neonatology, Department of Pediatrics, PGIMER, Chandigarh 160 012, India. sourabhdutta@yahoo.co.in.
authors.forename: V S
authors.initials: VS
authors.lastname: Sharma
authors.forename: S
authors.initials: S
authors.lastname: Dutta
authors.forename: N
authors.initials: N
authors.lastname: Taneja
authors.forename: A
authors.initials: A
authors.lastname: Narang
mesh_terms: D018592:Cross-Over Studies; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal / Q000379:methods*; D009726:Nurses