Infection Control Today - 06/2004: Study Evaluating Hand

Study Evaluating Hand Antiseptic Shows Improved Skin Condition With Use

By Julie Mahan

In late 1999, a small one-week trial for a new 3M waterless antiseptic was conducted in a home for individuals with mental retardation.

The ICF-MR facility had previously provided direct-care staff and floor nurses with a leading waterless alcohol sanitizer. Staff complained of the unpleasant odor, skin irritation and dryness resulting from use of this product. As a result, many staff no longer used the sanitizer, returning to traditional handwashing or no handwashing.

Based on the overwhelmingly positive response to the trial product, we offered to be a beta site for a longer three-week study that would introduce all of our direct-care staff to this product.

Objective

To determine the effectiveness and moisturizing ability of Avagard D Instant Hand Antiseptic, while comparing skin condition and staff preference with our current product and traditional handwashing.

Conclusion

Healthcare providers visually and physically perceived skin health benefits with new 3M Avagard D Instant Hand Antiseptic throughout the study period. The skin condition of employees in all categories that were measured improved. Of the participants who completed the study, 90 percent indicated a desire to continue to use Avagard D hand antiseptic.

Method

Twenty-nine staff members who were currently using the facilityprovided sanitizer volunteered to use the Avagard D Antiseptic in addition to handwashing for a three-week period. Hand condition was self-evaluated by the participants prior to the start of the study using four parameters: appearance, intactness, moisture content and sensation (defined as itching, burning, and soreness).1 Participants rated their hand condition on a scale of 1 to 7, with 1 being the worst and 7 being the best. After the first and second weeks, participants completed a questionnaire on their hand condition in the same four categories. After the third and final week, the same categories and questions remained, as well as additional questions about handwashing and product preferences.

Avagard D Antiseptic was placed near most incontinent-care tables as well as by all the sinks in the facility. Participants were also provided with personal-size bottles to place on medicine and shower carts.

Of the 29 initial participants, four did not reliably contribute to the study, three discontinued use after the first week, and two discontinued use after the second week due to increased skin irritation. It can be speculated that the skin irritation was due to the introduction of an alcohol-based product to already-sore hands. Three of the five who left the study had not used hand sanitizer before trying Avagard D hand antiseptic. One participant stated that she preferred petroleum jelly to lotion or hand sanitizer.

Results

Pre-trial results revealed poor skin condition with people complaining of itching, redness, and dryness. After the first week, participants noticed more moisturizing effects, less redness, and less skin breakdown with multiple daily uses of Avagard D hand antiseptic than with the previous sanitizer or traditional handwashing. Staff members also noted that the emollient- based formulation of Avagard D hand antiseptic felt smooth on their hands, compared with a slimy feel of the previous product used. They also reported that their hands felt less dry after application.

After the second week, participants continued to see noticeable improvement in moisture content and reported more intact skin, less soreness, and better overall skin appearance.

The results indicate a slight decline in hand skin condition after the third week, with the exception of sensation, which continued to improve. Sensation, or itching, burning and soreness, was one of the chief complaints of participants at the beginning of the study. Although staff members reported a slight decrease in skin condition, using Avagard D hand antiseptic clearly improved the skin condition of our direct-care staff and nurses from the beginning to the end of the study.

Discussion

The results in all hand-skin condition categories measured improved by a minimum of 1.79 points (intactness) and a maximum of 2.57 points (moisture content). Of the 20 staff members who completed the full study, 18 indicated a desire to continue to use Avagard D hand antiseptic.

By improving hand-skin condition in a manner that can be visually and physically perceived by healthcare staff, it is likely that the frequency of hand cleansing and disinfection may increase. In addition, other studies done by 3M have proved Avagard D hand antiseptics effective antisepsis, without the need for water.2

Avagard D hand antiseptic has also been shown to be compatible with both chlorhexidine gluconate (CHG) and latex gloves.2

The improvement in skin condition and rate of satisfaction among staff support the continued use of Avagard D hand antiseptic in our facility.

At the time of writing, Julie Mahan worked as a QMRP/case manager for individuals with disabilities in an ICF-MR in Austin, Texas, but is currently a second-year dual-degree student in law and disability studies at Syracuse University. She graduated from UT Austin in May 1999 with a bachelors degree in English and German

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