Hospitals Abandoning Soap and Water

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Hospitals Abandoning Soap and Water

Sun Sep 29, 2:19 AM ET

By DANIEL Q. HANEY, AP Medical Editor

SAN DIEGO - Soap and water may be all washed up. Many hospitals are

switching to quick-drying alcohol gels to keep hands clean as evidence

builds they stop dangerous germs faster and better.

The spread of microbes in hospitals is a huge health problem, making sick

people sicker and resulting in an estimated 20,000 deaths in the United

States each year. One of the chief ways germs spread is on the hands of

nurses, doctors, technicians and others who move from patient to patient.

While hospital workers are routinely urged to wash up between patients, a

thorough job can take a full minute, results in dry skin and is often

skipped to save time, especially in hectic intensive care wards where the

risk can be greatest.

The latest research, presented Saturday at a meeting of the American Society

for Microbiology, suggests the alcohol-based rinses are surprisingly

effective at cutting hospital germs, since they are much quicker, require no

water or sink and kill more microbes.

" You go up to a dispenser, go " click! " and it's there. The time saving is

amazing. It's something people actually do use rather than walking by the

sink, " said Dr. Barbara Murray of the University of Texas at Houston.

Over the past two years, some hospitals have installed alcohol gel

dispensers beside every bed, and many more are planning to switch. New

guidelines from the Centers for Disease Control and Prevention ( news - web

sites), to be released later this fall, are expected to recommend hospitals

use the alcohol gels exclusively except when workers hands are visibly

soiled.

" This will represent a revolution in hand hygiene, " said nurse Elaine

Larson, associate dean for research at Columbia University. " No longer is

the best way to clean your hands washing them. Can you imagine telling

surgeons you no longer need to scrub? This is news, and it's very exciting. "

The alcohol rinses, available as foam, gel or lotion, are simple to use:

Pour a dime-size blob on one palm, then rub the hands together until it

dries, which takes about 15 seconds. The solutions also contain

moisturizers, so they do not dry the skin. Identical products are available

in grocery stores.

" One of the real barriers to hand hygiene is how busy health care workers

are, " said Dr. Hooper of Massachusetts General Hospital. " The ability

to very rapidly kill bacteria on your hands is a great advantage. "

Researchers at the Veterans Administration Medical Center in Washington D.C.

measured the effects of switching to the alcohol rinses two years ago.

Dispensers were put in all patient rooms and outpatient clinics.

New cases of drug-resistant staph infections decreased 21 percent, while

resistant enterococcus dropped 43 percent. Both of these are serious,

hospital-acquired infections.

Among the first to study the gel's advantages was Dr. Didier Pittet of the

University of Geneva Hospitals in Switzerland. Four years of use there cut

hospital-spread infections in half.

Some hospitals have been reluctant to adopt the new cleaners because they

cost more than soap. However, a new analysis by Pittet suggests they

actually save money because they reduce infections, which are expensive to

treat.

At his hospital, he found the gels cost an extra $1.62 for each patient

admitted, or $82,000 per year. But between 1999 and 2001, they save more

than $12 million in treatment costs.

Many brands are available. The solutions contain between 60 percent and 90

percent alcohol and are thought to be equally effective in killing viruses

and bacteria. They are also being tested in school bathrooms and child care

centers, among other places.

Larson said she does not recommend replacing ordinary soap in the home.

However, the alcohol rubs could be helpful if people are traveling and

cannot wash, have sick children or care for people with weakened immune

systems