title: Provision and consumption of alcohol-based hand rubs in European hospitals.
abstract: Hand hygiene is considered to be the most effective way of preventing microbial transmission and healthcare-associated infections. The use of alcohol-based hand rubs (AHRs) is the reference standard for effective hand hygiene. AHR consumption is a valuable surrogate parameter for hand hygiene performance, and it can be easily tracked in the healthcare setting. AHR availability at the point of care ensures access to optimal agents, and makes hand hygiene easier by overcoming barriers such as lack of AHRs or inconvenient dispenser locations. Data on AHR consumption and availability at the point of care in European hospitals were obtained as part of the Prevention of Hospital Infections by Intervention and Training (PROHIBIT) study, a framework 7 project funded by the European Commission. Data on AHR consumption were provided by 232 hospitals, and showed median usage of 21 mL (interquartile range (IQR) 9-37 mL) per patient-day (PD) at the hospital level, 66 mL/PD (IQR 33-103 mL/PD) at the intensive-care unit (ICU) level, and 13 mL/PD (IQR 6-25 mL/PD) at the non-ICU level. Consumption varied by country and hospital type. Most ICUs (86%) had AHRs available at 76-100% of points of care, but only approximately two-thirds (65%) of non-ICUs did. The availability of wall-mounted and bed-mounted AHR dispensers was significantly associated with AHR consumption in both ICUs and non-ICUs. The data show that further improvement in hand hygiene behaviour is needed in Europe. To what extent factors at the national, hospital and ward levels influence AHR consumption must be explored further.
authors.affiliation: Charité - University Medicine Berlin, Institute for Hygiene, Berlin, Germany. Electronic address: sonja.hansen@charite.de.
authors.forename: S
authors.initials: S
authors.lastname: Hansen
authors.affiliation: Charité - University Medicine Berlin, Institute for Hygiene, Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schwab
authors.affiliation: Charité - University Medicine Berlin, Institute for Hygiene, Berlin, Germany.
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authors.lastname: Gastmeier
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authors.lastname: Pittet
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authors.lastname: Zingg
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authors.lastname: Sax
authors.forename: P
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authors.lastname: Gastmeier
authors.forename: S
authors.initials: S
authors.lastname: Hansen
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authors.initials: H
authors.lastname: Grundmann
authors.forename: B
authors.initials: B
authors.lastname: van Benthem
authors.forename: T
authors.initials: T
authors.lastname: van der Kooi
authors.forename: M
authors.initials: M
authors.lastname: Dettenkofer
authors.forename: M
authors.initials: M
authors.lastname: Martin
authors.forename: H
authors.initials: H
authors.lastname: Richet
authors.forename: E
authors.initials: E
authors.lastname: Szilágyi
authors.forename: O E
authors.initials: OE
authors.lastname: Központ
authors.forename: P B
authors.initials: PB
authors.lastname: Heczko
authors.forename: A
authors.initials: A
authors.lastname: Holmes
authors.forename: Y
authors.initials: Y
authors.lastname: Kyratsis
authors.forename: R
authors.initials: R
authors.lastname: Ahmad
authors.forename: B
authors.initials: B
authors.lastname: Allegranzi
authors.forename: A
authors.initials: A
authors.lastname: Magiorakos
authors.forename: B
authors.initials: B
authors.lastname: Cookson
authors.forename: A W
authors.initials: AW
authors.lastname: Wu
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D003428:Cross Infection / Q000517:prevention & control; D005060:Europe; D006235:Hand Disinfection / Q000379:methods*; D064548:Hand Sanitizers / Q000008:administration & dosage*; D006306:Health Surveys; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D019095:Point-of-Care Systems / Q000706:statistics & numerical data
chemical_list: D000891:Anti-Infective Agents, Local; D064548:Hand Sanitizers
keywords: Europe; HAI prevention; hand hygiene; hand rub consumption; hospital