Assessment of alternative hand hygiene regimens to improve skin health among neonatal intensive care unit nurses

Objective: The frequent handwashing and gloving required in high-risk, high-volume patient care areas such as critical care units damages skin of the hands. The purpose of this exploratory study was to compare 2 hand care regimens (traditional antiseptic wash with chlorhexidine-containing detergent versus mild soap wash with subsequent alcohol-based rinse for degerming as necessary) in a neonatal intensive care unit (NICU). Design: Prospective, quasi-experimental, random assignment. Setting: One NICU (47 beds) in a New York City children’s hospital. Subjects: Sixteen full-time NICU nurses. Outcome Measures: Microbial flora and skin condition of hands. Intervention: Nurses were randomly assigned to one of the 2 hand care regimens. Results: No significant differences in microbial counts or types of organisms from hands of staff were found, but after 2 weeks nurses in the mild soap and alcohol group had significant improvements in their skin condition (P =.005). Conclusions: Use of a mild soap for cleaning and an alcohol-based product for degerming may offer an acceptable alternative to the traditional antiseptic handwash and may reduce skin damage to health care professionals’ hands. (Heart Lung® 2000;29:136-42)