Comparison of traditional hand wash with alcoholic hand rub in ICU setup

Background: Nosocomial infection rate are often higher for intensive care unit (ICU) than other units of hospitals, and hands of health-care workers (HCWs) play a major role in the transmission of the infections.
Aim: To compare the efficacy of conventional hand wash with the hand rub in reducing the transient bacterial flora on the hands of nurses in ICU.
Subject and Methods: The 34 nurses posted in our ICU during January-March 2003 were included. A total of 204 samples were collected for the residual bacterial flora on fingers using impression method on MacConkey agar plates. The subjects then used alcoholic hand rub or conventional hand wash and the residual bacterial flora rechecked by testing impression of fingers on MacConkey agar.
Results: Escherichia coli, Klebsiella spp., nonlactose fermenting Gram-negative bacilli, staphylococci, and streptococci formed the transient bacterial flora on the hands. Moderate to heavy bacterial density was seen in more than 92.2% of the hands before washing or hand rub application. Conventional hand wash resulted in drastic reduction in the transient bacterial flora on hands in 50% cases whereas alcoholic hand rub achieved the effect in 95% of the samples.
Conclusion: Compared with conventional hand wash, alcoholic hand rub is far more efficient in reducing transient bacterial flora on the hands of HCWs and it is more convenient and time saving. It is recommended as a hand hygiene practice in critical areas such as ICU.