Product dose considerations for real-world hand sanitiser efficacy.

Area of Science:

• Infection Control and Prevention
• Healthcare Epidemiology
• Microbiology

Background:

• Alcohol-based hand rubs (ABHR) are vital for effective hand hygiene and reducing microbial contamination.
• The World Health Organization (WHO) emphasizes ABHR as a cornerstone of best practice hand hygiene protocols.

Purpose of the Study:

• To determine the drying time of ABHR during hand hygiene in a laboratory setting.
• To identify the optimal volume of ABHR for complete hand coverage.
• To analyze real-time data on ABHR usage in hospitals and monitor healthcare workers' (HCWs) perceptions and drying times.

Main Methods:

• Laboratory assessment of ABHR drying times and required volumes for hand coverage.
• Real-time data collection on ABHR usage in clinical hospital settings.
• Monitoring of HCWs' hand drying times and subjective perceptions of ABHR application.

Main Results:

• A single dose of ABHR was used in 86% of observed events on clinical wards.
• HCWs expected hand hygiene to take a median of 7.5 seconds.
• While 1.5 mL of ABHR met WHO guidelines for drying time (median 26 seconds), HCWs perceived it as shorter (median 18 seconds).
• In-vivo testing indicated 2.25 mL of ABHR is necessary for adequate hand coverage (82%-90%).

Conclusions:

• Current standards for ABHR use do not align with observed HCW practices.
• Perceived drying times for ABHR are shorter than the actual time required for efficacy.
• The recommended drying time for achieving acceptable antimicrobial efficacy of ABHR warrants re-evaluation.