{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:47:35Z","timestamp":1761630455392},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2007,5,3]],"date-time":"2007-05-03T00:00:00Z","timestamp":1178150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2007,5,3]],"date-time":"2007-05-03T00:00:00Z","timestamp":1178150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>Hand hygiene is one of the cornerstones of the prevention of health care-associated infection, but health care worker (HCW) compliance with good practices remains low. Alcohol-based handrub is the new standard for hand hygiene action worldwide and usually requires a system change for its successful introduction in routine care. Product acceptability by HCWs is a crucial step in this process.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>We conducted a prospective intervention study to compare the impact on HCW compliance of a liquid (study phase I) versus a gel (phase II) handrub formulation of the same product during daily patient care. All staff (102 HCWs) of the medical intensive care unit participated. Compliance with hand hygiene was monitored by a single observer. Skin tolerance and product acceptability were assessed using subjective and objective scoring systems, self-report questionnaires, and biometric measurements. Logistic regression was used to estimate the association between predictors and compliance with the handrub formulation as the main explanatory variable and to adjust for potential risk factors.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Overall compliance (phases I and II) with hand hygiene practices among nurses, physicians, nursing assistants, and other HCWs was 39.1%, 27.1%, 31.1%, and 13.9%, respectively (<jats:italic>p<\/jats:italic> = 0.027). Easy access to handrub improved compliance (35.3% versus 50.6%, <jats:italic>p<\/jats:italic> = 0.035). Nurse status, working on morning shifts, use of the gel formulation, and availability of the alcohol-based handrub in the HCW's pocket were independently associated with higher compliance. Immediate accessibility was the strongest predictor. Based on self-assessment, observer assessment, and the measurement of epidermal water content, the gel performed significantly better than the liquid formulation.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>Facilitated access to an alcohol-based gel formulation leads to improved compliance with hand hygiene and better skin condition in HCWs.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc5906","type":"journal-article","created":{"date-parts":[[2007,5,3]],"date-time":"2007-05-03T18:25:21Z","timestamp":1178216721000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Liquid versus gel handrub formulation: a prospective intervention study"],"prefix":"10.1186","volume":"11","author":[{"given":"Ousmane","family":"Traore","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Hugonnet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jann","family":"L\u00fcbbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Griffiths","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Didier","family":"Pittet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2007,5,3]]},"reference":[{"key":"5388_CR1","first-page":"1","volume":"51","author":"JM Boyce","year":"2002","unstructured":"Boyce JM, Pittet D: Guideline for hand hygiene in health-care settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC\/SHEA\/APIC\/IDSA Hand Hygiene Task Force. Society for Healthcare Epidemiology of America\/Association for Professionals in Infection Control\/Infectious Diseases Society of America.\n                           MMWR 2002, 51: 1-45.","journal-title":"MMWR"},{"key":"5388_CR2","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S1473-3099(09)70295-6","volume":"1","author":"D Pittet","year":"2001","unstructured":"Pittet D, Boyce JM: Hand hygiene and patient care: pursuing the Semmelweis legacy.\n                           Lancet Infect Dis 2001, 1: 9-20. 10.1016\/S1473-3099(01)00015-9","journal-title":"Lancet Infect Dis"},{"key":"5388_CR3","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/S0140-6736(05)66912-7","volume":"366","author":"SP Luby","year":"2005","unstructured":"Luby SP, Agboatwalla M, Feikin DR, Painter J, Billhimer W, Altaf A, Hoekstra RM: Effect of handwashing on child health: a randomized controlled trial.\n                           Lancet 2005, 366: 225-233. 10.1016\/S0140-6736(05)66912-7","journal-title":"Lancet"},{"key":"5388_CR4","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S0140-6736(05)66886-9","volume":"366","author":"D Pittet","year":"2005","unstructured":"Pittet D: Clean hands reduce the burden of disease.\n                           Lancet 2005, 366: 185-187. 10.1016\/S0140-6736(05)66886-9","journal-title":"Lancet"},{"key":"5388_CR5","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1001\/archinte.160.7.1017","volume":"160","author":"WE Bischoff","year":"2000","unstructured":"Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP: Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic.\n                           Arch Intern Med 2000, 160: 1017-1021. 10.1001\/archinte.160.7.1017","journal-title":"Arch Intern Med"},{"key":"5388_CR6","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1164\/ajrccm.162.1.9908118","volume":"162","author":"E Maury","year":"2000","unstructured":"Maury E, Alzieu M, Baudel JL, Haram N, Barbut F, Guidet B, Offenstadt G: Availability of an alcohol solution can improve hand disinfection compliance in an intensive care unit.\n                           Am J Respir Crit Care Med 2000, 162: 324-327.","journal-title":"Am J Respir Crit Care Med"},{"key":"5388_CR7","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1016\/S0140-6736(00)02814-2","volume":"356","author":"D Pittet","year":"2000","unstructured":"Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV: Effectiveness of a hospital-wide programme to improve compliance with hand hygiene.\n                           Lancet 2000, 356: 1307-1312. 10.1016\/S0140-6736(00)02814-2","journal-title":"Lancet"},{"key":"5388_CR8","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/j.ajic.2006.05.289","volume":"34","author":"E Larson","year":"2006","unstructured":"Larson E, Girard R, Pessoa-Silva CL, Boyce J, Donaldson L, Pittet D: Skin reactions related to hand hygiene and selection of hand hygiene products.\n                           Am J Infect Control 2006, 34: 627-635. 10.1016\/j.ajic.2006.05.289","journal-title":"Am J Infect Control"},{"key":"5388_CR9","volume-title":"WHO guidelines for hand hygiene in health care (advanced draft)","author":"World Health Organization","year":"2006","unstructured":"World Health Organization: WHO guidelines for hand hygiene in health care (advanced draft). 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Frosch","year":"1979","unstructured":"Frosch PJ, Kligman AM: The soap chamber test.\n                           J Am Acad Dermatol 1979, 1: 35-41.","journal-title":"J Am Acad Dermatol"},{"key":"5388_CR18","doi-asserted-by":"publisher","first-page":"1037","DOI":"10.1001\/archinte.162.9.1037","volume":"162","author":"S Hugonnet","year":"2002","unstructured":"Hugonnet S, Perneger TV, Pittet D: Alcohol-based handrub improves compliance with hand hygiene in intensive care units.\n                           Arch Intern Med 2002, 162: 1037-1043. 10.1001\/archinte.162.9.1037","journal-title":"Arch Intern Med"},{"key":"5388_CR19","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1086\/313468","volume":"29","author":"E Larson","year":"1999","unstructured":"Larson E: Skin hygiene and infection prevention: more of the same or different approaches?\n                           Clin Infect Dis 1999, 29: 1287-1294. 10.1086\/313468","journal-title":"Clin Infect 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gluconate\/ethanol-emollient antiseptic preparation with a conventional water-applied product.\n                           Am J Infect Control 2001, 29: 361-369. 10.1067\/mic.2001.118619","journal-title":"Am J Infect Control"},{"key":"5388_CR25","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/j.1365-2133.2000.03708.x","volume":"143","author":"M Winnefeld","year":"2000","unstructured":"Winnefeld M, Richard MA, Drancourt M, Grob JJ: Skin tolerance and effectiveness of two hand decontamination procedures in everyday hospital use.\n                           Br J Dermatol 2000, 143: 546-550. 10.1111\/j.1365-2133.2000.03708.x","journal-title":"Br J Dermatol"},{"key":"5388_CR26","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1086\/501785","volume":"21","author":"JM Boyce","year":"2000","unstructured":"Boyce JM, Kelliher S, Vallande N: Skin irritation and dryness associated with two hand-hygiene regimens: soap-and-water hand washing versus hand antisepsis with an 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Uter","year":"1998","unstructured":"Uter W, Gefeller O, Schwanitz HJ: An epidemiological study of the influence of season (cold and dry air) on the occurrence of irritant skin changes of the hands.\n                           Br J Dermatol 1998, 138: 266-272. 10.1046\/j.1365-2133.1998.02072.x","journal-title":"Br J Dermatol"}],"container-title":["Critical 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February 2007","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2007","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2007","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2007","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R52"}}