Maintaining intact skin during handwashing

Kovach & Associates Inc.e first line of defense against the chain of septic flow

Infection control professionals conclude proper handwashing by healthcare staff is the single most important method of controlling cross contamination potential during patient/resident handling activities. Maintaining the hands of the caregiver in a "intact and aseptic condition" can inhibit the flow of opportunistic microorganisms. The article presents data on how seven various current handwashing formulations/active ingredients now on the market achieve two key objectives:

1. Reduce microorganism loads on 1st initial application and be persistent during the patient care day after the 7th handwash application;

2. How each formulation/active ingredient achieves the goal of leaving the hands of the caregiver in an intact, moist condition after repeated handwash episodes.

Based on extensive bench testing results by Bioscience Laboratories in Bozeman, MT, this author concludes that all active ingredients work to achieve the above 2 goals but some work better than others. The effectiveness of one active ingredient over another often and the ability of the handwash or hand rinse product to leave caregiver hands in an intact condition depends on the actual formulation characteristics of the product. Most products now on the market are formulation dependent for effectiveness and moisture retention ability:

1. That CHG formulations remains the most effective active ingredient for initial and persistent log reduction of microorganisms;

2. That a new quat. handwash formulation is also almost as effective as CHG in achieving log reduction of microorganisms and also leaves the hands in a moist condition;

3. The best formulation in moisture retention was a alcohol based hand rinse formulation. This finding was surprising as alcohol has a tendency to dry out epidermal skin layers of caregiver skin. Again, the ability to reduce microorganisms loads on caregiver hands and to be able to remoisturize caregiver skin is a formula related analysis--not just an active ingredient discussion.

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