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Alcohol-based decontamination of gloved hands: A randomized controlled trial
Journal article   Open access   Peer reviewed

Alcohol-based decontamination of gloved hands: A randomized controlled trial

Kerri A Thom, Clare Rock, Gwen L Robinson, Heather R S Reisinger, Jure Baloh, Emily Chasco, Yuanyuan Liang, Shanshan Li, Daniel J Diekema, Loreen A Herwaldt, …
Infection control and hospital epidemiology, Vol.45(4), pp.467-473
04/2024
DOI: 10.1017/ice.2023.243
PMCID: PMC11007359
PMID: 37994538
url
https://doi.org/10.1017/ice.2023.243View
Published (Version of record) Open Access

Abstract

OBJECTIVEThe gold standard for hand hygiene (HH) while wearing gloves requires removing gloves, performing HH, and donning new gloves between WHO moments. The novel strategy of applying alcohol-based hand rub (ABHR) directly to gloved hands might be effective and efficient.DESIGNA mixed-method, multicenter, 3-arm, randomized trial.SETTINGAdult and pediatric medical-surgical, intermediate, and intensive care units at 4 hospitals.PARTICIPANTSHealthcare personnel (HCP).INTERVENTIONSHCP were randomized to 3 groups: ABHR applied directly to gloved hands, the current standard, or usual care.METHODSGloved hands were sampled via direct imprint. Gold-standard and usual-care arms were compared with the ABHR intervention.RESULTSBacteria were identified on gloved hands after 432 (67.4%) of 641 observations in the gold-standard arm versus 548 (82.8%) of 662 observations in the intervention arm (P < .01). HH required a mean of 14 seconds in the intervention and a mean of 28.7 seconds in the gold-standard arm (P < .01). Bacteria were identified on gloved hands after 133 (98.5%) of 135 observations in the usual-care arm versus 173 (76.6%) of 226 observations in the intervention arm (P < .01). Of 331 gloves tested 6 (1.8%) were found to have microperforations; all were identified in the intervention arm [6 (2.9%) of 205].CONCLUSIONSCompared with usual care, contamination of gloved hands was significantly reduced by applying ABHR directly to gloved hands but statistically higher than the gold standard. Given time savings and microbiological benefit over usual care and lack of feasibility of adhering to the gold standard, the Centers for Disease Control and Prevention and the World Health Organization should consider advising HCP to decontaminate gloved hands with ABHR when HH moments arise during single-patient encounters.Trial Registration: NCT03445676.

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