Hand decontamination: nurses' opinions and practices

Infection is spread in hospital mainly by hands, making hand decontamination the most important means of preventing dissemination. There is some evidence to suggest that when access to hand-decontaminating agents is poor or the agents available are disliked, hands are washed too seldom, increasing risks of cross-infection. However, little attention has been paid to the use of towels and factors which promote their use, although it is known that damp hands transfer bacteria more readily than dry ones and that hands which become sore through poor drying have higher bacterial counts, contributing to the risk of cross-infection. This paper reports the results of the Nursing Times Hand Drying survey designed to assess nurses' access to hand decontamination agents and towels. The results suggest that the 112 nurses who participated were aware of the need for attention to hand hygiene but that access to both hand-decontaminating agents and paper towels was variable. Forty-one per cent complained of a shortage of soap and although nearly all used paper towels, these were in many cases of poor quality. Such towels were perceived as damaging to hands, leaving them feeling damp and sore. Good-quality, soft, paper towels were much appreciated by respondents in this sample. It is concluded that the quality of paper towels contributes to good infection control practice.