Fact Source
C. difficile forms spores that are not killed by an alcohol-based hand sanitizer. 

CDC, Hand Hygiene in Healthcare. http://www.cdc.gov/handhygiene/science/index.html. Accessed December 8, 2016. 


Some health care providers clean their hands less than half of the number of times they should. 

CDC, Hand Hygiene in Healthcare Settings. http://www.cdc.gov/handhygiene/science/index.html. Accessed December 8, 2016. 


Hospital billing data collected by the federal Agency for Healthcare Research and Quality shows that more than 9% of C. diff-related hospitalizations end in death — nearly five times the rate for other hospital stays.  

Hospital Stays Involving C. difficile Infections Leveled Off After 300 Percent Increase Since 1993. AHRQ News and Numbers, January 25, 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/nn/nn012512.htm Accessed: August 14, 2012 


 The rate of compliance with hand hygiene is significantly lower when gloves were worn.

 

 C. Fuller, J. Savage, S. Besser, A. Hayward, B. Cookson, B.Cooper, S. Stone.
“The Dirty Hand in the Latex Glove”: A Study of Hand Hygiene Compliance When Gloves Are Worn. Infection Control and Hospital Epidemiology. 32(12):1194-1199.


One quarter of respondents (27%) were aware of another staff member failing to wash their hands or change gloves before touching a patient's access site.

Health and Safety Survey to Improve Patient Safety in End Stage Renal Disease, page 19 


Most catheters have bacteria in a biofilm layer within 24 hours of insertion. Analysis of infections show that most infections come from bacteria commonly located on the surface of skin. Organisms can migrate from the skin insertion site or from the hands of medical personnel. 

P. J. Blankestijn, "Treatment and Prevention of Catheter-Related Infections in Haemodialysis Patients," Nephrology Dialysis Transplantation 16, no. 10 (Oct 2001): 1975-1978. A. K. Saxena, B.R. Panhotra, "Haemodialysis Catheter-Related Bloodstream Infections: Current Treatment Options and Strategies for Prevention," Swiss Medical Weekly 135, no. 9-10 (March 5, 2005): 127-138. 


In a Network study, patient's vs. staff's view of handwashing differ significantly:

Patient's View: Past 3 months:
11% of patients report seeing nurses or technicians who fail to wash hands or change gloves before touching a patient's access or change gloves before touching their access site.

Staff's View: Past 3 months:
27% professionals reported observing staff fail to wash hands or change gloves before touching a patient's access. 

Health and Safety Survey to Improve Patient Safety in End Stage Renal Disease, page 


The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. Gloves reduce hand contamination by 70 percent to 80 percent, prevent cross-contamination and protect patients and health care personnel from infection. Alcohol-based hand rubs should be used before and after each patient just as gloves should be changed before and after each patient. 

Centers for Disease Control and Prevention "Hand Hygiene Guidelines Fact Sheet," fact sheet, 25 October 2002, http://www.cdc.gov/od/oc/media/pressrel/fs021025.htm (accessed July 10, 2008). 


Alcohol-based hand rubs are more effective and take less time to use than traditional hand washing. In an eight-hour shift - an estimated one hour of an ICU nurse's time will be saved by using an alcohol-based hand rub.

Centers for Disease Control and Prevention "Hand Hygiene Guidelines Fact Sheet," fact sheet, 25 October 2002, http://www.cdc.gov/od/oc/media/pressrel/fs021025.htm (accessed July 10, 2008). 


Alcohols are not appropriate for use when hands are visibly dirty or contaminated with proteinaceous materials.

Centers for Disease Control and Prevention "Guidelines for Hand Hygiene in Health-Care Settings" October 25, 2003, http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm
(accessed August 5, 2008). 


...alcohol-based hand rubs may not be as effective against spore-forming bacteria.

Centers for Disease Control and Prevention "Frequently Asked Questions, Information for Healthcare Providers"  Released August 2004; Updated 07/22/2005
http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html#1
accessed August 5, 2008) 


Hemodialysis patients tend to be among the first to experience antibiotic-resistant pathogens. The first vancomycin-resistant enterococci (VRE) cases were reported from a dialysis unit, the first reported case of vancomycin-resistant Staphylococcus aureus, and three of the first five reported patients infected with vancomycin-intermediate Staphylococcus aureus (VISA) or glycopeptides-intermediate Staphylococcus aureus (GISA) were on hemodialysis.

M. J. Arduino, J. I. Tokars, "Why is an Infection Control Program Needed in the Hemodialysis Setting?" Nephrology News Issues 19, no. 7 (June 2005): 44, 46-49.