Nursing: Hand-washing and Hand Sanitizer

Introduction

Many people are paranoid about the spread of germs, especially nurses and doctors while they are working. This is a natural fear, but never should hand sanitizers replace the traditional and thorough practice of hand-washing with soap and water. Nurses should use more hand soap and water to wash their hands than hand sanitizer in order to protect the patients. Although it may take longer than hand sanitizer, using soap and water is more efficient in preventing the spread of germs in a hospital environment.

Background of the Problem

In the United States, patients in hospitals get almost 2 million infections per year. Broken down, every 20 patients will get an infection. These can be minor or life-threatening and difficult to treat. Because of these statistics, hand hygiene is “one of the most important ways to prevent the spread of infections” including Clostridium Difficile, Influenza, and the common cold (2012). The problem is simple: hand sanitizer is simply too convenient and it causes even the cleanliest of nurses to skip hand-washing and go straight for the hand sanitizer. According to Annette Jeanes at Nursing Times, hands should be washed at these key times: when they are visibly soiled, before a sterile procedure, whenever they may feel dirty or sticky, and following applications of a decontaminant gel (2005). Hand-washing is very important in the medical environment.

The Food and Drug Administration’s regulations on food services state that hand sanitizers only be used as a supplement and never has a substitute for hand-washing (Mulkins, 2004). Barbara Almanza of Purdue University has said that: “by the same token, people should not use hand sanitizers in place of a good lathering with soap and water if it's available” (Mulkins, 2004). The manufacturer’s claim is that hand sanitizers are 99.9 percent effective in killing germs, however, “the physiological complexity of human skin makes it difficult for testing” (Mulkins, 2004). As well, alcohol sanitizers are extremely flammable, and this is a hazard.

As well, another issue is that people are using hand sanitizers completely while discarding the use of traditional hand-washing. Hand sanitizers contain a very high level of alcohol. This is the primary selling point for the highest-selling brands because alcohol is what kills the germs. However, because of the high alcohol content (upward past 60 percent alcohol) is that it is oftentimes abused. “Though (ethyl alcohol) kills most bacteria that cause tuberculosis, food poisoning, diarrhea and wound infection, its active ingredient (62 percent ethyl alcohol) has no effect on viruses” (Mulkins, 2004). Hand sanitizer has a significantly higher alcohol concentration than several common alcoholic drinks, such as beer and common spirits.

Ethyl alcohol is the active ingredient in hand sanitizers, especially those that actually do clear out as many germs as they claim. “The inactive ingredients--glycerin, propylene glycol, tocopherol acetate, isopropyl myristate, and aminomethyl propanol--generally are recognized as safe by the FDA and the Cosmetic Ingredient Review Expert Panel” (Francois, et al, 2012). Misuse of these products is gaining popularity, and even become commonplace in hospitals and prisons, and other medical units (Francois, et al, 2012). Such a high level of alcohol can simply not be safe in every situation, especially when it is on every corner in a convenient dispenser.

Significance to the Field

Of course, the problem is that too many are become dependent on hand sanitizers and do not practice good hand-washing. Although these hand sanitizers are ‘convenient,’ they should not be the only mode in which nurses and doctors make sure that they have clean hands. Nurses tend to use more hand sanitizer more often during a typical 12-hour shift than they do practicing hand-washing. Unfortunately, although the high content of alcohol does kill the most basic germs, it harms skin over time and can cause healthy germs on the skin to be lost. There are risks in the use of hand sanitizers and they outweigh the benefits over a longer period of time. As well, the clean practice of washing hands with soap should never be skipped to save a few seconds. It is too much of a risk to oust traditional hand-washing for alcohol-based hand sanitizers.

References

Centers for Disease Control and Prevention. (2012). Hand Hygiene in Healthcare Settings. Retrieved from http://www.cdc.gov/handhygiene/Basics.html.

Francois, D., Klingman, D., & Kotbi, N. (2012). The hidden danger of hand sanitizer. Health and Wellness Resource Center. Gale Cengage Learning, 11 (4): 70.

Jeanes, A. (2005). Handwashing. Nursing Times. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-zones/infection-control/handwashing/203785.article.

Mulkins, P. (2004). Do hand sanitizers beat soap and water? Tulsa World. Retrieved from http://search.proquest.com/docview/400148808?accountid=458.