New Survey Shows One-Third of Health Care Professionals Don't Follow Evidence-Based Guidelines For Skin Antisepsis

SAN DIEGO, Nov. 15, 2010 /PRNewswire/ -- A survey released today of 1,500 hospital-based health care professionals reveals that 33 percent report they do not follow evidence-based guidelines and data for patient skin antisepsis.

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This finding is especially surprising given that the survey, which was conducted by Infection Control Today and sponsored by CareFusion (NYSE: CFN), shows health care professionals -- many of whom are responsible for infection prevention at their facilities -- rank clinical data and guidelines as the most important consideration for selecting a product for skin antisepsis.  

"It's promising to see health care professionals recognize the importance of following established recommendations and guidelines for reducing health care-associated infections (HAIs), but it is disappointing that these guidelines aren't being put into practice more frequently," said Allan Morrison, Jr., MD, MSc, FACP, FIDSA, professor and distinguished senior fellow at George Mason University in the School of Public Policy. "Given that microorganisms on patients' skin are a primary cause of HAIs, skin antisepsis should be a top priority for institutions. Additionally, adherence to clinical guidelines by all health care professionals - regardless of specialty or tenure - is critical. Fortunately, skin antisepsis measures are relatively inexpensive and easy to implement."

The study examined practices and perceptions of hospital-based health care workers with regard to use of chlorhexidine gluconate (CHG) skin antisepsis. Numerous published studies support the use of 2 percent CHG and CHG-based formulations for patient preoperative skin preparation to help reduce bacteria that can cause skin infections.

Survey reveals differences by specialty, tenure

Length of time in clinical practice was a major determinant for how important vigilance with skin antisepsis was perceived for reducing infections. Those with less than 20 years in practice ranked skin antisepsis as higher in importance for reducing infections compared to those with 20 or more years of experience.

The survey also revealed significant differences between the practices of infection preventionists versus. health care professionals who were not specialists in this area. For example, 77 percent of infection preventionists said they use CHG products for patient skin antisepsis compared to only about half of other health care professionals (53 percent).

A more startling difference was found in the reported use of a combination of CHG and alcohol for patient skin antisepsis by infection preventionists compared to other health care professionals. According to the survey, 56 percent of infection preventionists cited a combination of CHG and alcohol as most commonly used for patient skin antisepsis at their institution, compared to just 36 percent of health care professionals who were not infection preventionists. Also, more health care professionals not specialized in infection prevention reported the use of iodine alone as most commonly used within their institution - 14 percent vs. 5 percent of infection preventionists. This difference signals a gap between the reported importance of data and guidelines compared to implementation in clinical practice. For example, data published this year in The New England Journal of Medicine demonstrate that use of 2 percent CHG and 70 percent isopropyl alcohol when compared to use of povidone-iodine solution reduced total surgical site infections (SSIs) by 41 percent, (16.1 percent vs. 9.5 percent).

The problem of HAIs

HAIs are a major public health concern in the United States.(1) Patients who develop HAIs have longer hospital stays, use more health care resources, such as IV antibiotics and clinician care, and are at greater risk for readmission and death.(2)

It has been established that HAIs can be reduced with proper hand antisepsis by health care professionals.(3) Recommendations and guidelines, including those from the U.S. Centers for Disease Control and Prevention (CDC) and the World Health Organization, state that health care professionals should clean their hands with an alcohol-based hand-scrub (such as SurgiceptTM - 70% Ethyl alcohol), prior to patient contact or putting on gloves. Interestingly, the survey results revealed that health care workers perceive hand hygiene as the most important factor in reducing the risk of infection following any in-patient medical procedure.

For preoperative patient skin antisepsis, a clinically proven 2 percent CHG formulation is a key component. CHG is recommended for patient skin antisepsis by at least 18 organizations and initiatives, including the CDC and the National Institutes of Health, with 10 organizations specifically advocating for the use of a 2 percent CHG formulation, such as ChloraPrep® patient preoperative skin prep (2 percent chlorhexidine gluconate and 70 percent isopropyl alcohol).

About the survey

The survey, conducted from September 15 through September 29, 2010 by Infection Control Today and supported by CareFusion, was designed to understand the practices and perceptions of hospital-based health care workers with regard to use of skin antisepsis. In total, 15,000 surveys were sent, resulting in a 10 percent response rate. Survey respondents included infection preventionists, epidemiologists, hospital administrators or materials managers, staff nurses and other health care workers.

About ChloraPrep patient preoperative skin prep  

ChloraPrep patient preoperative skin preparation - a combination of 2 percent chlorhexidine gluconate and 70 percent isopropyl alcohol - is a proven antiseptic designed to prepare patients' skin for a broad range of major and minor surgical procedures by reducing the number of microorganisms on the skin. The ChloraPrep patient preoperative skin prep formulation helps in two ways: Isopropyl alcohol rapidly kills microorganisms while chlorhexidine maintains persistent antimicrobial activity. Further, the applicator's soft sponge gently scrubs the skin to help the solution penetrate the first five layers of the epidermis, where 80 percent of microorganisms reside. The applicator minimizes direct hand-to-patient contact, helping reduce the risk of cross-contamination.

About Surgicept waterless surgical hand antiseptic

Surgicept(4) waterless antiseptic surgical hand scrub (70 percent ethyl alcohol) is an effective waterless surgical hand scrub. Its unique patented formulation is proven to meet and exceed FDA requirements for surgical hand scrubs. Surgicept waterless surgical hand scrub antiseptic kills 99.99 percent of bacteria in vitro in 15 seconds and requires only a two minute scrub protocol.(5) Surgicept waterless surgical hand scrub dries quickly and unlike other surgical scrubs, it leaves no sticky, tacky build up or greasy residue, which makes it easier to glove and eliminates glove slippage or the need to towel dry. The unique, patented formulation of Surgicept waterless antiseptic surgical hand scrubalso includes emollients to counter the drying effects of alcohol.

About CareFusion  

CareFusion (NYSE: CFN) is a global corporation serving the health care industry with products and services that help hospitals measurably improve patient care. The company develops market-leading technologies including Alaris® IV pumps, Pyxis® automated dispensing and patient identification systems, AirLifeTM, AVEA® and LTV® series of ventilators and respiratory products, ChloraPrep® skin prep products, MedMinedTM services for infection surveillance, V. Mueller® and Snowden-Pencer® surgical instruments and NeuroCare diagnostic products. CareFusion employs more than 15,000 people across its global operations. More information may be found at