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Hand Hygiene Products and Their Effect on Skin Condition at High Compliance: The Need for Better Product Formulations
Changes to the Centers for Medicare and Medicaid payment policies has resulted in an intensified focus on reducing healthcare-associated infections, including increasing hand hygiene compliance. Hand hygiene is the most important measure for preventing transmission of pathogens, but as compliance increases, skin health can decrease. Soap is usually the culprit, and changing practice to primarily use hand sanitizer can help significantly, but only up to a point. Current formulations may not adequately address skin health needs that arise in very high compliance environments. There is a need to develop products that adequately address skin health needs in these situations.

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Hand Hygiene in Healthcare Settings: A Summary
The most common mode of transmission of pathogens is via the hands of healthcare workers and hand hygiene is accepted as one of the most important measures for preventing transmission of pathogens in health-care facilities. There is substantial evidence that hand hygiene reduces the incidence of healthcare-associated infections (HAI). Alcohol-based hand rubs have been widely adopted in healthcare facilities because of their convenience, speed of use, skin health benefits, ability to be used independently of sinks, and superior efficacy. In a laboratory setting, plain soaps reduce bacterial counts, but antimicrobial soaps are better, and ABHR are best. Because of this, the Centers for Disease Control and Prevention (CDC) included the recommendation that ABHR should be used in the majority of clinical situations in their 2003 Guideline for Hand Hygiene in Health-Care Settings. Further, the World Health Organization (WHO) affirmed these recommendations in their 2009 Guidelines on Hand Hygiene in Health Care. It is important to note that there are caveats to the use of ABHR, and they include when hands are visibly soiled or contaminated with blood or other bodily fluids. In these situations, the use of either antimicrobial or non-antimicrobial soap and water is warranted.

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