Hand Washing Versus Alcohol Based Sanitizers

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Hand sanitation has long been known to reduce the spread of disease and today alcohol based hand sanitizers are used in addition to washing hands with soap and water. Currently there are evidence based practices (EBP) guidelines for hand sanitization versus hand washing for bedside nurses. There’s currently significant evidence for using one method over the other but some barriers prevent the proper level of sanitation.

Significance to Practice

Healthcare acquired infections (HCI) are very common in today’s hospitals and new forms of drug resistant organisms have emerged limitation of the spread of these organisms are of great significance. Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Clostridium difficile(CDIF), surgical site infections, urinary tract infections, and ventilator related pneumonias are common HCI’s. Surgical site infections alone according to an annual report from the Colorado Department of public health estimates national financial toll of 3-10 billion dollars.


Some common barriers to healthcare workers can be cost, access to hand sanitation stations or materials and lack of knowledge of current best care practices. Lack of proper hand hygiene increases the likely hood of a healthcare acquired infection. Cost to the hospital and the patient increases with longer hospital stays and more treatment required. Current practices should not be changed but education in the reasoning of these practices needs to be increased in the healthcare community.

Research Literature

Several articles specifically address not just hand hygiene but specifically hand washing or the use of alcohol based hand sanitizers.

Article 1: “Putting Evidence Into Nursing Practice: ...

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... and more effective if hands are not visibly soiled but studies are still examining the use on soiled hands.

Works Cited

Pickering, A. J., Davis, J., & Boehm, A. B. (2011). Efficacy of alcohol-based hand sanitizer on hands soiled with dirt and cooking oil. Journal of water and health, 9(3), 429-433.

Flynn, Martin, S. A., Burns, S., Philbrick, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 33(2), 28-44. doi:10.4037/ccn2013787

Patrick, M., and Van Wicklin, S. A. (2012). Implementing AORN Recommended Practices for Hand Hygiene. AORN journal, 95(4), 492-507.

World Health Organization. (2009). WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK144041/

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