Effect of Antiseptic Handwashing vs Alcohol Sanitizer on Health Care- Associated Infections in Neonatal Intensive Care Units

Introduction

This article seeks to determine if alcohol hand sanitizers are as effective as

antiseptic handwashing at reducing or eliminating health care associated infections in a

neonatal intensive care unit. The Centers for Disease Control and Prevention, Atlanta,

GA, recommends use of waterless alcohol hand products in lieu of traditional

handwashing for patient care, but there is little data demonstrating the impact of this

recommendation on health-associated infections.

Protection of Human Participants

76.8% (119/155) of eligible nurses agreed to participate in the study and had one

or more hand cultures performed. The primary reason nurses refused to participate was

unwillingness to perform study procedures, such as completing diary cards. Over the

course of the study, 12 nurses withdrew, 9 because they left the study NICU, and 3

because they no longer wanted to participate. Nurses completed 1070 daily dairy cards.

No informed consent was obtained.

Data Collection

A clinical trial using a crossover design in two neonatal ICU’s in Manhattan, NY

from 3-1-2001 to 1-31-2003, including 2,932 neonatal hospital admissions (51,760

patient days) and 119 nurse participants. Two hand hygiene products were tested, a

traditional antiseptic handwash and an alcohol hand sanitizer. Each product was used for 11 consecutive months in each neonatal ICU in random order. Many things were

factored into this study.

* Incidence rates were calculated by the number of incident infections per 1000 patient days for all infections combined, skin and soft tissue infections, central nervous system infections, and conjunctivitis. Consistent with NNIS protocols, incidence