Alcohol Hand Disinfection as an Alternative to the Presurgical Scrub: One Hospital's Experience
D SPENCE*1, E.A. BRYCE2, A.WALSH2, L. HARRIS2, F.J. ROBERTS1 AND SCHARF2.
1 British Columbia Cancer Agency and 2Vancouver General Hospital, Vancouver B.C.

Objective: To describe the results of an in-use study of alcohol hand rub for the presurgical scrub and the staged implementation process for introduction of the product to all operative (OR) areas.

Methods: An in-issue evaluation of a 70% isopropanol presurgical hand disinfectant was conducted in the OR suites at two hospital sites. The hand disinfectant was compared to agents in current use as surgical scrubs using pre- and post-operative fingertip impression and "glove juice" cultures to determine microbial burden. Following the study, a staged implementation process was begun with OR areas prioritized as to size and ease of implementation. Prior to introduction of the product in each area, notices were distributed to OR staff and educational sessions were conducted. Infection control and company staff were available in the Ors for the first week of implementation at each site with follow-up visits occurring on a regular basis.

Results: No statistical difference between microbial hand counts for the alcohol-based product and traditional scrub agents for cases less than two hrs duration was found. Longer surgical cases had significantly better results with the alcohol hand rinse pre- and post-operatively, however, analysis of matched pairs showed no significant difference in microbial counts. The alcohol hand rinse preserved skin integrity during the study period and after one year of use. More than 90% of the staff have switched to the alcohol hand rinse.

Conclusion: 70% isopropanol is an effective, highly accepted presurgical disinfectant. Staged implementation was an efficient way to introduce the change from "scrub to rub."

The Canadian Journal of Infection Control Fall 2001
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