The World Health Organization and the Centers for Disease Control guidelines have been driving hand hygiene practices for more than a decade. These guidelines specify that handwashing with soap and water is the preferred means when hands are visibly dirty or soiled with blood or body fluids, after using the restroom, and with suspected (or confirmed) outbreaks of spore-forming pathogens including Clostridium difficile. In all other clinical situations, routine hand hygiene should involve alcohol-based hand rubs (ABHRs). ABHRs typically contain ethanol, n-propanol, and isopropanol at concentrations of 60% to 95%, offering fast-acting broad-spectrum antimicrobial action.3,4 

Nurses encounter hundreds of hand hygiene opportunities every day. Of these hand hygiene events, use of ABHRs varies widely by setting. A recent systematic review indicated that nurses used ABHRs no more than 15 times per hour and 141 times...

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