alcohol based Hand rubs - Nursing Science

Introduction

In the fast-paced environment of healthcare, maintaining hand hygiene is a fundamental practice for preventing the spread of infections. Among the various methods available, alcohol-based hand rubs (ABHR) have become a cornerstone in clinical settings. This article delves into the importance, effectiveness, proper usage, and potential drawbacks of ABHR in the context of nursing.

Why Use Alcohol-Based Hand Rubs?

ABHRs are preferred in many healthcare settings because they are quick and effective. They require less time than traditional handwashing with soap and water, are more accessible, and are less irritating to the skin. Moreover, they have been proven to reduce the burden of pathogens on the hands of healthcare workers, thereby lowering the risk of healthcare-associated infections (HAIs).

What Makes ABHR Effective?

The primary active ingredient in ABHRs is alcohol, usually in the form of ethanol, isopropanol, or n-propanol. These alcohols are effective against a wide range of microorganisms, including bacteria, viruses, and fungi. The concentration of alcohol in ABHRs typically ranges between 60% and 95%, as this range is most effective for killing germs.

When Should Nurses Use ABHR?

Nurses should use ABHR in the following situations:

Before and after direct contact with patients.
Before performing any aseptic tasks.
After exposure to body fluids, even if gloves were worn.
After touching patient surroundings or medical equipment.
Before donning and after doffing gloves.

How to Use ABHR Properly?

The correct technique for using ABHR is crucial for its effectiveness. Here are the steps:

Apply a palmful of ABHR (about 3-5 ml) to the cupped hand.
Rub hands palm to palm.
Interlace fingers and rub the back of each hand with the palm of the other hand.
Interlace fingers and rub the backs of fingers to opposing palms.
Rotationally rub each thumb clasped in the opposite hand.
Rub fingertips and nails against the opposite palm.
Continue rubbing until the hands are dry, which should take around 20-30 seconds.

Are There Any Drawbacks?

While ABHRs are highly effective, they do come with certain limitations:

Skin Irritation: Frequent use can lead to dryness and irritation of the skin. This can usually be managed by using products containing moisturizers.
Ineffectiveness Against Certain Germs: ABHRs are not effective against all types of pathogens, such as Clostridium difficile and certain non-enveloped viruses.
Not Suitable for Soiled Hands: ABHRs are less effective when hands are visibly dirty or greasy. In such cases, handwashing with soap and water is recommended.

Conclusion

Alcohol-based hand rubs play an essential role in maintaining hand hygiene in nursing. They are quick, effective, and convenient, making them a valuable tool in the fight against healthcare-associated infections. However, it's important for nurses to be aware of their proper use and limitations to maximize their benefits. By adhering to hand hygiene guidelines and using ABHRs correctly, nurses can significantly contribute to a safer healthcare environment.