Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare
Abstract Background The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. Aim To evaluate the impact of ABHR volume, application time, rubbing friction and hand size...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13756-021-01049-9 |
| _version_ | 1819364592886743040 |
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| author | Lesley Price Lucyna Gozdzielewska Julius Cesar Alejandre Annelysse Jorgenson Emma Stewart Didier Pittet Jacqui Reilly |
| author_facet | Lesley Price Lucyna Gozdzielewska Julius Cesar Alejandre Annelysse Jorgenson Emma Stewart Didier Pittet Jacqui Reilly |
| author_sort | Lesley Price |
| collection | DOAJ |
| description | Abstract Background The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. Aim To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time. Methods Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. Findings Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (− 0.70; 95%CI: − 1.13 to − 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. Conclusions There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20–30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size. |
| first_indexed | 2024-12-24T23:01:24Z |
| format | Article |
| id | doaj.art-8f2b64bb7ed6441cbda7d11bc79c5cbc |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-24T23:01:24Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-8f2b64bb7ed6441cbda7d11bc79c5cbc2022-12-21T16:35:06ZengBMCAntimicrobial Resistance and Infection Control2047-29942022-01-0111112210.1186/s13756-021-01049-9Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcareLesley Price0Lucyna Gozdzielewska1Julius Cesar Alejandre2Annelysse Jorgenson3Emma Stewart4Didier Pittet5Jacqui Reilly6SHIP Research Group, Research Centre for Health, Glasgow Caledonian UniversitySHIP Research Group, Research Centre for Health, Glasgow Caledonian UniversitySHIP Research Group, Research Centre for Health, Glasgow Caledonian UniversitySHIP Research Group, Research Centre for Health, Glasgow Caledonian UniversityMRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley SquareInfection Control Programme and WHO Collaborating Center on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, GenevaSHIP Research Group, Research Centre for Health, Glasgow Caledonian UniversityAbstract Background The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. Aim To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time. Methods Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. Findings Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (− 0.70; 95%CI: − 1.13 to − 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. Conclusions There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20–30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size.https://doi.org/10.1186/s13756-021-01049-9Hand hygieneAlcohol-based handrubSystematic reviewVolumeApplication time |
| spellingShingle | Lesley Price Lucyna Gozdzielewska Julius Cesar Alejandre Annelysse Jorgenson Emma Stewart Didier Pittet Jacqui Reilly Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare Antimicrobial Resistance and Infection Control Hand hygiene Alcohol-based handrub Systematic review Volume Application time |
| title | Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare |
| title_full | Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare |
| title_fullStr | Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare |
| title_full_unstemmed | Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare |
| title_short | Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare |
| title_sort | systematic review on factors influencing the effectiveness of alcohol based hand rubbing in healthcare |
| topic | Hand hygiene Alcohol-based handrub Systematic review Volume Application time |
| url | https://doi.org/10.1186/s13756-021-01049-9 |
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