By Julie Mahan
In late 1999, a small one-week trialfor a new 3M waterless antiseptic was conducted in a home for individuals withmental retardation.
The ICF-MR facility had previously provided direct-care staffand floor nurses with a leading waterless alcohol sanitizer. Staff complained ofthe unpleasant odor, skin irritation and dryness resulting from use of thisproduct. As a result, many staff no longer used the sanitizer, returning totraditional handwashing or no handwashing.
Based on the overwhelmingly positive response to the trialproduct, we offered to be a beta site for a longer three-week study that wouldintroduce all of our direct-care staff to this product.
To determine the effectiveness and moisturizing ability ofAvagard D Instant Hand Antiseptic, while comparing skin condition and staffpreference with our current product and traditional handwashing.
Healthcare providers visually and physically perceived skinhealth benefits with new 3M Avagard D Instant Hand Antiseptic throughout thestudy period. The skin condition of employees in all categories that weremeasured improved. Of the participants who completed the study, 90 percentindicated a desire to continue to use Avagard D hand antiseptic.
Twenty-nine staff members who were currently using thefacilityprovided sanitizer volunteered to use the Avagard D Antiseptic inaddition to handwashing for a three-week period. Hand condition wasself-evaluated by the participants prior to the start of the study using fourparameters: appearance, intactness, moisture content and sensation (defined asitching, burning, and soreness).1 Participants rated their hand condition on ascale of 1 to 7, with 1 being the worst and 7 being the best. After the firstand second weeks, participants completed a questionnaire on their hand conditionin the same four categories. After the third and final week, the same categoriesand questions remained, as well as additional questions about handwashing andproduct preferences.
Avagard D Antiseptic was placed near most incontinent-caretables as well as by all the sinks in the facility. Participants were alsoprovided with personal-size bottles to place on medicine and shower carts.
Of the 29 initial participants, four did not reliablycontribute to the study, three discontinued use after the first week, and twodiscontinued use after the second week due to increased skin irritation. It canbe speculated that the skin irritation was due to the introduction of analcohol-based product to already-sore hands. Three of the five who left the studyhad not used hand sanitizer before trying Avagard D hand antiseptic. One participant stated that she preferred petroleum jelly tolotion or hand sanitizer.
Pre-trial results revealed poor skin condition with peoplecomplaining of itching, redness, and dryness. After the first week, participantsnoticed more moisturizing effects, less redness, and less skin breakdown with multiple daily uses of Avagard D hand antiseptic than with theprevious sanitizer or traditional handwashing. Staff members also noted that theemollient- based formulation of Avagard D hand antiseptic felt smooth on theirhands, compared with a slimy feel of the previous product used. They alsoreported that their hands felt less dry after application.
After the second week, participants continued to seenoticeable improvement in moisture content and reported more intact skin, lesssoreness, and better overall skin appearance.
The results indicate a slight decline in hand skin conditionafter the third week, with the exception of sensation, which continued toimprove. Sensation, or itching, burning and soreness, was one ofthe chief complaints of participants at the beginning of the study. Althoughstaff members reported a slight decrease in skin condition, using Avagard D handantiseptic clearly improved the skin condition of our direct-care staff andnurses from the beginning to the end of the study.
The results in all hand-skin condition categories measuredimproved 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, 18indicated a desire to continue to use Avagard D hand antiseptic.
By improving hand-skin condition in a manner that can bevisually and physically perceived by healthcare staff, it is likely that thefrequency of hand cleansing and disinfection may increase. In addition, otherstudies done by 3M have proved Avagard D hand antiseptics effectiveantisepsis, without the need for water.2
Avagard D hand antiseptic has also been shown to be compatiblewith both chlorhexidine gluconate (CHG) and latex gloves.2
The improvement in skin condition and rate of satisfactionamong staff support the continued use of Avagard D hand antiseptic in ourfacility.
At the time of writing, Julie Mahan worked as a QMRP/casemanager for individuals with disabilities in an ICF-MR in Austin, Texas, but iscurrently a second-year dual-degree student in law and disability studies atSyracuse University. She graduated from UT Austin in May 1999 with a bachelorsdegree in English and German