Using Alcohol-based Hand Rubs Vs Hand Washing

The use of alcohol-based hand-rub products (eg, liquid, gel, or foam hand sanitizers) does not substitute for
hand washing in the group care setting. Hand washing is required to remove visible soil. Alcohol-based hand rubs should be limited to instances in which no sink is available. These products require an alcohol content of 60% or greater to be effective at killing germs. They are highly toxic if ingested by children, and they are flammable.

Caregivers/teachers should do the following:

• Limit the use of alcohol-based hand  rubs to areas of the facility that are  inaccessible to children (eg, in a kitchen that is off-limits to children or the maintenance equipment area).
• Discourage alcohol-based hand rubs for hand  hygiene  in child-use areas. If they are used in these areas because of lack of sinks, ensure that no child can have independent use of the container or dispenser.
• Be sure that hand hygiene using alcohol-based  hand rubs conforms to the manufacturer’s instructions. The procedure for using alcohol-based rubs should include the following:
  • Apply the required volume of the product to the palm of one hand and rub together; cover all surfaces of the hands and fingers until the hands are dry. The
    required volume should keep the hand surfaces wet for at least 15 seconds or longer if indicated by the manufacturer.
  • Check the dispenser systems for hand-hygiene rubs on a regular schedule to be sure they deliver the
    required volume of the product and do not become clogged or malfunction in some other way.
  • Store supplies of alcohol-based hand rubs in cabinets or areas approved for flammable materials.
  • Monitor hand hygiene with unannounced and regular direct observation. When hand rubs are used,
    check how much of the product is being used to be sure the appropriate amount gets used as a way to
    verify that the staff who are authorized to use this method of hand hygiene are continuing to use the material properly.

Source: Excerpted from Managing Infectious Diseases in Child Care and Schools, 2nd Edition. Click here for AAP Bookstore www.aap.org/bookstore.