Abstract
Objective:
Hand hygiene using either 4% chlorhexidine gluconate (CHG) or natural soap during hand rubbing, followed by alcohol-based 1% CHG sanitizer lotion in the operating room was compared to assess bacterial reduction, skin moisture, skin texture, and hand hygiene using qualitative questionnaires.
Approach:
A crossover study with 36 professional scrub nurses at two medical centers was performed to compare 4% CHG followed by alcohol-based 1% CHG sanitizer lotion, the Two-stage method with handwashing using natural soap followed by alcohol-based 1% CHG sanitizer lotion, and the Waterless method, after a period of 10 days of use. The study completely followed CONSORT,
Results:
There was no significant difference in bacterial reduction based on the bacterial colony-forming units between the two methods. The skin moisture and skin roughness scores were not significantly different between the two methods. The Waterless method was significantly better than the Two-stage method regarding “foaming,” “quality,” “longevity” (p < 0.0001, p < 0.0001, and p < 0.0001, respectively), but “disappearance” was significantly better by the Two-stage method (p = 0.0095) during washing and rubbing. Immediately after washing and rubbing, the Waterless method was significantly better regarding “tightness” and “moisture,” whereas the Two-stage method was significantly better regarding “stickiness” (p = 0.0114, p = <0.0001, and 0.0059, respectively)
Innovation:
The Waterless method using natural soap during handwashing followed by alcohol-based 1% CHG sanitizer lotion was as effective as the Two-stage method of 4% CHG followed by alcohol-based 1% CHG sanitizer lotion.
Conclusion:
Handwashing using natural soap is simple and superior to hand scrubbing in several aspects.
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