1 2 Recognition and management of an outbreak of infection

Infection Prevention Solutions

Surgical / antiseptic scrub

This is an extended hand decontamination procedure using hand wash products containing antiseptic skin cleansers e.g. chlorhexidine or povidone-iodine. Alternatively, alcohol-based products can also be used. This type of hand wash is only required when removal of resident micro-organisms is required e.g. prior to surgical procedures and certain high risk invasive procedures.

Types of hand decontamination products

Alcohol-based hand rubs (ABHRs)

Alcohol-based hand products – usually rubs, gels or foams are currently recognised as being the primary method of hand decontamination for most health care interventions where rapid hand decontamination is required at the point of use.

ABHRs are also useful where adequate facilities are not available e.g. when caring for service users in their own homes.

Alcohol is inactivated in the presence of organic matter i.e. body fluids etc. and therefore is not to be used on soiled hands.

ABHRs should be purchased from an approved supplier of medical products thus ensuring that an appropriate product suitable for healthcare activities is supplied and of the required strength (usually 70%) and type (usually isopropanol). Alcohol products should be used from wall-mounted dispensers (see below) or can be provided for individual staff use in bottles that can be attached to uniforms thus ensuring that the product is available at the point of care.

Alcohol is not as effective as soap and water in removing Clostridium difficile spores or some viruses including Norovirus and must therefore not be used whilst caring for service users with diarrhoeal illness.

Liquid soap products

These products are used for hand decontamination interventions that require the removal of transient micro-organisms and soiling. Products should be purchased from an approved supplier of medical products e.g. NHS Supply Chain as these products have been independently evaluated and economies of scale will be achieved with regards to cost. Bar soap should not be used for hand decontamination by healthcare staff as it can harbour micro-organisms.

Soap impregnated wipes should not be routinely used by health care workers who require a more thorough hand decontamination that is best provided by the use of soap and running water. Soap impregnated wipes are useful in, for example care homes for service users prior to meals and after using toilet facilities and in other circumstances where access to a hand wash basin is impaired. Since 2020 more enhanced hand hygiene interventions have lead to the widespread use of universal (multi-purpose) wipes rather than soap-impregnated wipes with alcohol-based