Understanding the variables that determine ABHR efficacy

Author: Christine Claighen, Regulatory and Scientific Manager, GOJO Australasia
For 70 years, GOJO has been a leader in infection control and skin science. We are your single source provider to help increase hand hygiene compliance, reduce infections and improve patient outcomes. We offer a wide range of comprehensive, science-based solutions to increase hand hygiene compliance – including revolutionary, skin-friendly formulations in PURELL® and GOJO® brands; with smart, easy-to-use touch free and manual dispensing platforms.
Our reputation is based on formulations that provide advanced germ kill, improved skin health and skin feel that make healthcare workers want to use our products. PURELL® Antiseptic Hand formulations (Gel and Foam) and GOJO® skin care formulations are tested to ensure the health and safety of staff, patients and visitors.
PURELL Antiseptic Hand gel and foam are both approved in Australia as hand sanitisers with a 1.1ml efficacious dose1,2. PURELL Antiseptic Hand gel is also approved for dual function as a waterless surgical scrub when sufficient product to keep hands and forearms wet for 120 seconds is applied. PURELL® Antiseptic Hand Gel and Foam are effective against a broad spectrum of organisms, including viruses and antibiotic resistant organisms.
Both the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) agree that hand hygiene is the single most important step a caregiver can take to prevent the spread of infections in the healthcare setting.3,4 The CDC and WHO Hand Hygiene Guidelines recommend that soap and water should be used when hands are visibly soiled or after contact with spores such as Clostridium difficile. For all other moments or opportunities for hand hygiene in the healthcare setting, both guidelines state that alcohol based hand rub (ABHR) is recommended. ABHR is preferred because it offers superior antimicrobial efficacy, better skin tolerability under high frequency use, greater convenience and time savings, all of which contribute to better end user acceptability and higher compliance.
Because product dry time is directly proportional to the amount of product applied to the hands, there is a practical limit to the volume of product that can be used without disrupting healthcare workflow. If healthcare workers (HCWs) must use 5 mL of product to achieve efficacy, they will not have the time to rub it in until dry. The ideal product application quantity is one that minimizes workflow disruption while maintaining maximum antimicrobial efficacy.5 Therefore, product literature should be examined to compare the quantity of product used in Healthcare Personal Hand Wash (ASTM E1174) or EN 1500 tests, the in vivo efficacy methods to evaluate ABHRs, to realistic in-use volumes. It is important to know how much product a HCW would need to rub in to achieve transient bacteria kill and how that corresponds to the volume of product that is dispensed during each actuation from your facility’s dispensers.
Total product formulation and product application volume, not alcohol concentration or product form, are the key determinants of the in vivo antimicrobial efficacy of an ABHR6,7. Because formulation plays an important role in ABHR antimicrobial efficacy, critical examination of in vivo efficacy data along with the quantity of product applied to hands in the test should be conducted when comparing antimicrobial efficacy of products. Finally, hand hygiene compliance is perhaps the most critical element to achieving clinical outcomes. For this reason, the most effective ABHRs are those that balance antimicrobial efficacy with skin performance and healthcare worker acceptability to ensure maximal compliance to hand hygiene practices.
For more information visit www.purell.com