ROLE OF HAND SANITIZERS

IN INFECTION CONTROL
AMONG HEALTH CARE
WORKERS (HCWs)
To be presented by:
OKE, MUSHAFAU ADEBAYO

SKP PHARMA LTD.

5, Vori Close, off Acme Road, Ogba, Lagos.
 INTRODUCTION
 Hospital-associated infections represent a serious and growing
health problem. (Harley et. al., 1985)

 The Centers for Disease Control and Prevention (CDC)

estimates that approx. 2 million people acquire hospital-
associated infections each year and that approx. 90 000 of these
patients die as a result of their infections. (Zerr, et. al. 2005)
 Healthcare workers carry antibiotic-resistant bacteria, fungi, and
viruses on their hands and act as a vector of transmission.
( http://www.med.yale.edu/ynhh/infection/presentations/slide3.html)

 The CDC and many other experts promote hand hygiene as the
single most important measure in the prevention of hospital-
associated infections. (Boyce and Pitter, 2002)
Hand Hygiene has 2 major components which are:
 Handwashing - removal of microorganisms (germs) with
(ordinary) soap and water.
 Hand Antisepsis - removal or destruction of microorganisms
using an antimicrobial soap or an alcohol-based hand rub.

 Despite the evidence and expert opinion supporting hand

hygiene, many studies have shown that health care workers
perform it approx. 50% of the times they should. (Zerr, et. al. 2005)

 Barriers to HCW hand hygiene compliance:

 lack of time
 skin damage that accompanies frequent washing with soap
and water.
 What are hand sanitizers?
 alcohol-containing preparations designed for application to
the hands for reducing the number of viable microorganisms
on the hands. (CDC, 2002).
 They are used for avoiding the transmission of pathogens.
 supplements or alternatives to hand washing with soap and
water. (FDA, 2009).
 Types
 Various preparations are available, including gel, foam, and
liquid solutions.
 Active Ingredients
 isopropanol, ethanol, n-propanol, or povidone-iodine.
 Inactive Ingredients
 a thickening agent such as polyacrylic acid for alcohol gels,
 humectants such as glycerin for liquid rubs,
 propylene glycol, and essential oils of plants.

 Antimicrobial Activity
 antimicrobial activity of alcohols can be attributed to their
ability to denature proteins (Larson and Morson, 1991) and possibly by
dissolving membrane lipids (Prescott et. al., 2002).
 Alcohol solutions containing 60%–95% alcohol are most
effective,
 higher concentrations are less potent because proteins are
not denatured easily in the absence of water (Larson and Morson, 1991).
 Alcohol-based hand gels address the barriers to HCW hand
hygiene compliance:
 they require a fraction of the time for effective hand washing
(Mody et. al., 2003)
 they are less damaging to the skin than soap and water. (Boyce
et. al., 2000)

 more effective in killing many microorganisms (Larson et. al., 2001)

 Studies have demonstrated increased frequency of hand hygiene

and decreased frequency of hospital-associated infections with
provision of alcohol hand gels in the context of institution- wide
hand hygiene campaigns. (Zerr, et. al., 2005)
 Spectrum of Activity
 Bacteria and Fungi:
 germicidal activity against gram-positive and gram-
negative vegetative bacteria
 multidrug-resistant pathogens (e.g., MRSA (Methicillin-
resistant Staphylococcus aureus) and VRE (Vancomycin-resistant
Enterococci))
 Mycobacterium tuberculosis, and various fungi

(Price (1939, 1938); Sakuragi et. al., 1995; Kampf et. al., 1999.)
 very poor activity against bacterial spores, protozoan oocysts,
and certain non-enveloped (nonlipophilic) viruses. (Coulthard and
Sykes, 1936)
 Spectrum of Activity (contd.)
 Viruses:
 herpes simplex virus, human immunodeficiency virus
[HIV], influenza virus, respiratory syncytial virus, and
vaccinia virus)
 Hepatitis B and C are susceptible to 60-70% alcohol.

 rotavirus, adenovirus and rhinovirus are susceptible to 60-

70% ethanol and 70% isopropanol .
 Hepatitis A and some enteroviruses are susceptible to 70-
80% ethanol.
(Platt and Bucknall, 1985; Krilov and Harkness, 1993; Sattar et al, 2001)
 Effects on skin
 rapidly germicidal when applied to the skin. However,
regrowth of the normal skin flora occurs slowly after use (Lilly
et. al., 1979).
 the drying effect of alcohol on the skin can be reduced or
eliminated by adding 1%–3% glycerol or other skin-
conditioning agents (Walter, 1965).

 Alcohol-based sanitizers vs. ordinary/antimicrobial

soaps
 an alcohol-based rinse can prevent pathogen transmission
more effectively than can handwashing with plain soap and
water when the hands of HCWs are heavily contaminated.
(Ehrenkranz and Alfonso, 1991)
 Alcohol-based sanitizers vs. ordinary/antimicrobial
soaps (contd.)
 alcohol-based products reduced the number of multidrug-
resistant pathogens recovered from the hands of HCWs more
effectively than did handwashing with plain soap and water
(Huang et al, 1994).
 alcohol reduced bacterial counts on hands more than

washing hands with antimicrobial soaps or detergents

(containing hexachlorophene, povidone- iodine, 4%
chlorhexidine, or triclosan) (Casewell et al, 1988)
 alcohol-based rinses or gels containing emollients caused
substantially less skin irritation and dryness than the soaps or
antimicrobial detergents tested (Boyce et al, 2000).
 How to use
 Apply enough of the product to the palm of your hand to wet
your hands completely.
 Rub your hands together, covering all surfaces until they are
dry.
 around the fingernails,
 between the fingers,
 on the back of the thumb,
 and around the wrist
 If your hands are visibly dirty, however, wash with soap and
water. [CDC, 2002 and Mayo Clinic, 2009 ]
 When to Use
 For HCW
 Before entering a patient’s room
 After contact with a patient
 After removing gloves (
http://www.med.yale.edu/ynhh/infection/presentations/slide15.html )
 Others
 Before:
 preparing food, eating, treating wounds or giving medicine,
touching a sick or injured person,
 inserting or removing contact lenses
 After
 preparing food (especially raw meat or poultry), using the toilet,
changing a diaper, touching an animal or animal toys, leashes or
waste, blowing your nose, coughing or sneezing into your hands,
treating wounds, touching a sick or injured person, handling
garbage or something that could be contaminated, such as a
cleaning cloth or soiled shoes. [Mayo Clinic, 2009)
 Religious Concerns
 Alcohol is considered haraam, or forbidden, in
Islamic tradition
 However, some Islamic scholars and The Muslim
Council of Britain state that the alcohol in hand
sanitizer used as medicine is halal, or permissible
[islamonline.net, 2009]
 because protection against disease is among the aims that
Muslims are commanded to pursue, so it is permissible to
touch [islamonline.net, 2009]
 the alcohol in hand sanitizer evaporates and is not
absorbed significantly through the skin so it cannot
cause intoxication.[(http:/ / www. ncbi. nlm. nih. gov/ pmc/ articles/
PMC1803104/ ) ]
 SKP HAND
SANITIZER GEL
Active ingredient: isopropyl alcohol 62%
Other ingredients:
•water
•glycerine
•propylene glycol
•fragrance
•triethanolamine
•carbopol 940
•acetate
•isopropyl myristate
 SKP HAND SANITIZER GEL
Features and Benefits

•kills up to 99.9% of common germs that can be

transmitted by contaminated hands.

•It is easy to use and dries quickly after rubbing

for at least 15 seconds.

•provides a better skin tolerance and microbial

killing strength when compared to antiseptic
soaps.

•It is a viable alternative to hand washing with

soap especially where there is no water or use of
water may not be appropriate.
 SKP HAND SANITIZER GEL
Features and Benefits
•First to be registered by NAFDAC in
Nigeria

•Portable (Different sizes -60ml and

120ml)

•Lemon fragrance

•Cheaper than imported brands

•Made in USA

•Availability
 Available
@
 Momrota Pharmacy, Oke Oyi & General, Ilorin.
 Ayo Pharmacy, Oke Oyi & Amilegbe, Ilorin.
 Mojlat Pharmacy, Lajorin Road, Muritala, Ilorin.
 Food & Nut Stores, Taiwo Road, Ilorin.
 Martrite Supermarket, GRA, Ilorin (very soon).
 Pharmacy outlets and supermarkets in Lagos &
Port-Harcourt.
We are hopeful that the management
and staff of this hospital will adopt
SKP Hand Sanitizer Gel in their effort
to promote hand hygiene as part of the
improved infection control measures.
 Other SKP Pharma Products
S/N Product Active Ingredients Intended Purpose
o Name

1 Glucotin DS Glucosamine,  Special formula for healthy joints and

Caps chondroitin, building block for joint and cartilage.
calcium, vitamin D.  Effective management of osteoarthritis.

2 Calcifer Iron, folic acid, calcium,  Amino acid Chelated calcium and iron for
Caps vit. B12, vit. D, maximum absorption.
magnesium,  Supplement for strong bones and rich blood.
manganese, etc.  Effective for anaemia and osteoporosis.

3 Osteoforte Calcium, vit. D, zinc,  For strong, healthy bones and active life.
Caps manganese, etc.
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