Assessment of the efficacy of a patient hand wipe: development of a test method

Much attention has focused on hand decontamination for healthcare workers, but little attention has been paid to patient hand hygiene. Patients confined to bed are often unable to access handwashing facilities. They could use an alcohol hand rub, but these are not advised for soiled hands or social hand hygiene. One alternative is the use of a hand wipe. However, it is important to ascertain the effectiveness of hand wipes for removal of transient micro-organisms from the hands.

To develop a method to assess the antimicrobial efficacy of hand wipes compared with handwashing, and thus determine if a hand wipe can be acceptable for patient hand hygiene.

The methodology was based on European Standards EN 1499 (2013) and EN 1500 (2013) as there is no standard for hand wipes. The hands of 20 healthy volunteers were contaminated artificially by immersion in Escherichia coli, and then sampled before and after the use of a reference soft soap or hand wipes for 60 s. The counts obtained were expressed as log₁₀, and the log₁₀ reductions were calculated.

The hand wipe with no antimicrobial agent (control wipe) was inferior to the soft soap. However, the antimicrobial hand wipe was statistically non-inferior to the soft soap. A log₁₀ reduction of 3.54 was obtained for the soft soap, 2.46 for the control hand wipe, and 3.67 for the antimicrobial hand wipe.

The evidence suggests that the antimicrobial hand wipe, when applied for 60 s, is at least as good as soap and water, representing an acceptable alternative to handwashing from a bactericidal perspective.