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time was about $60 for each 6-minute scrub and $20 for each 2-minute hand rub application, if manufacturers' directions were followed precisely.8 Although the study noted that the products' costs were similar, the shorter staff time made the alcohol rub product much more cost-effective. Additionally, Larson pointed out that each traditional scrub used 12 gallons of water and 38.6 grams of waste due to nail picks and packaging. The applications of alcohol hand rubs created
only 2.1 grams of waste and no water usage.8
Tavolacci reported that surgical hand rubs are 67% less expensive than traditional scrubs, based on the total cost of all products used in each method —
including a soap-and-water pre-wash before applying alcohol-based products, the use of the water filters often necessary to ensure water quality when traditional scrubs are used, and sterile towels.9 The report did not consider cost savings based on the staff time needed for each hand preparation procedure, however.
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ON THE WEB
Download references at
www.outpatientsurgery.net/forms
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The score
You may see greater and more precise compliance with waterless hand rubs instead of brush scrubs only. To review:
• Rubs are as effective or more effective at reducing bacterial counts on hands
than scrubbing.
• Rubs have been associated with equivalent or lower rates of surgical site infection.
• Skin condition after rubbing is better than it is after scrubbing.
• Some alcohol-based products contain emollients.
• Staff generally prefer hand rubs over scrubbing.
• Rubs offer major savings: staff time, ancillary equipment, water use and
waste disposal costs. OSM
Dr. Haas (janet.haas@nyumc.org) is associate director of the infection prevention and control department at New York University Medical Center in New York City.