By DANIEL Q. HANEY, AP Medical Editor SAN DIEGO - Soap and water may
be all washed up. Many hospitals are switching to quick-drying
alcohol gels to keep hands clean as evidence builds they stop
dangerous germs faster and better.
The spread of microbes in hospitals is a huge health problem, making
sick people sicker and resulting in an estimated 20,000 deaths in the
United States each year. One of the chief ways germs spread is on the
hands of nurses, doctors, technicians and others who move from
patient to patient.
While hospital workers are routinely urged to wash up between
patients, a thorough job can take a full minute, results in dry skin
and is often skipped to save time, especially in hectic intensive
care wards where the risk can be greatest.
The latest research, presented Saturday at a meeting of the
American Society for Microbiology, suggests the alcohol-based rinses
are surprisingly effective at cutting hospital germs, since they are
much quicker, require no water or sink and kill more microbes.
"You go up to a dispenser, go "click!" and it's there. The time
saving is amazing. It's something people actually do use rather than
walking by the sink," said Dr. Barbara Murray of the University of
Texas at Houston. Over the past two years, some hospitals have
installed alcohol gel dispensers beside every bed, and many more are
planning to switch.
New guidelines from the Centers for Disease Control and Prevention (
news - web sites), to be released later this fall, are expected to
recommend hospitals use the alcohol gels exclusively except when
workers hands are visibly soiled said nurse Elaine Larson, associate
dean for research at Columbia University. "No longer is the best way
to clean your hands washing them. Can you imagine telling surgeons
you no longer need to scrub? This is news, and it's very exciting."
The alcohol rinses, available as foam, gel or lotion, are simple
to use: Pour a dime-size blob on one palm, then rub the hands
together until it dries, which takes about 15 seconds. The solutions
also contain moisturizers, so they do not dry the skin. Identical
products are available in grocery stores.
"One of the real barriers to hand hygiene is how busy health care
workers are," said Dr. David Hooper of Massachusetts General
Hospital. "The ability to very rapidly kill bacteria on your hands is
a great advantage."
Researchers at the Veterans Administration Medical Center in
Washington D.C. measured the effects of switching to the alcohol
rinses two years ago.Dispensers were put in all patient rooms and
outpatient clinics. New cases of drug-resistant staph infections
decreased 21 percent, while resistant enterococcus dropped 43
percent. Both of these are serious, hospital-acquired infections.
Among the first to study the gel's advantages was Dr. Didier Pittet
of the University of Geneva Hospitals in Switzerland. Four years of
use there cut hospital-spread infections in half.
Some hospitals have been reluctant to adopt the new cleaners
because they cost more than soap. However, a new analysis by Pittet
suggests they actually save money because they reduce infections,
which are expensive to treat. At his hospital, he found the gels cost
an extra $1.62 for each patient admitted, or $82,000 per year. But
between 1999 and 2001, they save more than $12 million in treatment
costs. Many brands are available. The solutions contain between 60
percent and 90 percent alcohol and are thought to be equally
effective in killing viruses and bacteria. They are also being tested
in school bathrooms and child care centers, among other places.
Larson said she does not recommend replacing ordinary soap in the
home. However, the alcohol rubs could be helpful if people are
traveling and cannot wash, have sick children or care for people with
weakened immune systems.
http://story.news.yahoo.com/news?tmpl=story2&cid=541&e=4&u=/ap/200209
28/ap_on_he_me/clean_hands
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