Knowledge, practice, and opinions of surgical staff 1 year after implementing the use of an alcohol-based surgical hand-scrub product

BACKGROUND/OBJECTIVES: The use of an alcohol-based surgical hand scrub was implemented in the operating rooms (ORs) and invasive procedure units of our 1000-bed, academic medical center in October 2003. All staff members were inserviced, and product use was optional (traditional scrub remained available). One year after implementation a 30-question survey was distributed to assess product and practice knowledge level as well as participantsʹ opinions. METHODS: Four hundred surveys were distributed to all staff; 139 responses were returned (35%) and 30 incomplete forms were excluded, leaving 109 surveys to evaluate. Data were analyzed with EpiInfo software. RESULTS: The sample of respondents consisted of 53 surgeons/MDs (49%), 36 nurses (33%), OR technicians (9%), and 10 physician assistants (9%). The largest proportions of responses by service were general surgery (15%), cardiac catheterization (13%), and cardiothoracic surgery (11%). The product was used by respondents always 8% of the time, usually 21%, sometimes 41%, seldom 19%, and never 11%. Of the eight knowledge questions, 46% were not aware that chlorhexidine gluconate was a component of the product, and 91% did not select the correct duration of antimicrobial activity of the product. The average correct response to the six remaining knowledge questions was 87%. Practice questions disclosed that 30% always pre-prepared hands and nails appropriately prior to using the product and 58% complied with spreading remaining hand prep over the hand and above the elbow. Of the opinion questions, the product was preferred over traditional hand prep by 42% of respondents (47% preferred traditional, 11% neutral). Forty-six percent (46%) agreed that the hand prep had improved the condition of their hands, 33% were neutral, and 21.3% thought their hand condition had not improved. CONCLUSIONS: The survey disclosed that among respondents who used the product, 47% continued to prefer the traditional scrub and 42% preferred the new product. Knowledge and practice questions revealed a need for product inservice education during orientation and compliance monitoring. Only 46% thought the product had improved hand conditions, suggesting the need for continued product development.