Hand rub dose

Alcohol hand rubs are widely used in healthcare and are finding their way into the catering and waste management sectors also. They are fast, convenient, simple to use and more or less effective, but they are not a panacea.

Running a tutorial session for waste handlers the limitations of alcohol hand rubs became starkly apparent, with most users believing that they were universally effective and that their use provided long-lasting protection. Wrong! Wrong! Wrong!

  • Alcohol hand rubs are almost totally ineffective on dirty hands, for which soap and water are the only real solution
  • As soon as the last drop of alcohol has evaporated, antimicrobial activity is gone, unless a product with an additional active substance is used. In this case – usually a foam product – the actual dose is small and the efficacy over time is at best modest. There just isn’t enough antibacterial to make a real difference

 

The question of dose is particularly important. How much hand rub to use? This is clearly an important issue and we need to look critically at each hand rub dispenser. Many dispensers require adjustment of the delivered dose.

Smaller personal dispenser bottles deliver a clearly inadequate volume unless used to excess. A cursory squirt is not enough and the next step in hand hygiene promotion must be to ensure that a satisfactory dose is used every time.

There is only one study of hand rub dosage. The conclusion was clear – almost all users are using far too little. The rule of thumb [no pun] is to use enough hand rub to fill completely the cupped hand. This should be rubbed thoroughly over the hands and wrists, making sure to include the space between fingers, around nails and under rings etc, until the product has evaporated completely. Do not wipe off any excess.

many waste handlers are now using alcohol hand rubs. Dispenses are mounted at key locations – though I have seen these only once in the waste management areas of any NHS hospital  and for ancillary staff these are still sadly lacking – and available as personal dispensers for use by roundsmen.

This is a start, but as the dose may be far too small and general standards of hand hygiene are such as to make these products largely ineffective, the value of these hand rubs may be far less than is anticipated. This places workers at a significant risk, and creates an unhealthy but entirely false sense of security.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.