When clean running water is not available what is the clinical and cost effectiveness of using wipes, gels, handrubs or other products to remove visible contamination?
PICO questionPopulation: Community based healthcare workers
Intervention: All types of hand wipes, hand rinses, gels and handrubs used on physically dirty hands without running water.
Comparison: Each other
Outcomes: Colony forming units (CFUs) based on the Adenosine triphosphate (ATP) surface test or swabbing on agar plates.
Compliance with different methods and acceptability to healthcare workers.
Importance to patients or the populationNeed to know which products are effective and what healthcare workers should be using when running water is not available.
Relevance to NICE guidanceParticularly relevant to community based healthcare workers, especially the ambulance service.
Relevance to the NHSAs more care is being provided in the community and at patient’s residence setting, the evidence behind maintaining hand decontamination with no running water will be of vital importance to inform healthcare workers, patients, carers and patients undertaking care treatments what to do in this situation.
National prioritiesNo relevant national priorities
Current evidence baseNo RCT evidence was identified in the clinical review for hand decontamination without running water for the removal of blood and /or body fluid.
Study designRCT. Power calculations should be conducted to establish the required sample size of the trial. It is important that the study is adequately powered to detect a clinically important effect size.
Economic considerationsYes, this study would affect a large number of the population, including patient groups and community based healthcare workers.
FeasibilityThis proposed research should be able to be carried out within a realistic timescale and cost. There may be technical issues around conducting this as an RCT as compared to in laboratory settings.
EqualitiesNone identified.
Other commentsNone.

From: Appendix M, High priority research recommendations

Cover of Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care
Infection: Prevention and Control of Healthcare-Associated Infections in Primary and Community Care: Partial Update of NICE Clinical Guideline 2.
NICE Clinical Guidelines, No. 139.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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