الفهرس 
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Abstract
One of the main problems and challenges in the intensive care units (ICUs) is the hospital acquired infection. The ICUs are multidisciplinary units and invasive diagnostic and therapeutic interventions are used frequently for the critically ill patients. It was documented that the ICUs and the hospital acquired infections (HAIs) mainly attributed to the critical care nurses’ (CCNs) hands. Hand hygiene is an important issue at the forefront of the patient safety. Hand antisepsis should be performed routinely to reduce or inhibit the growth of microbial flora. Sterillium is one of the most commonly used alcoholic solutions. According to the literature, the use of this product can improve hand hygiene compliance, reduce rates of HAIs and acquisition of multi resistant bacteria.
Aim of the study: this study was conducted to evaluate the effect of hand antisepsis with strellium on bacterial colonization of critical care nurses’ hands.
Materials and method: to fulfill the aim of this study a quasi experimental research design was used. This study was carried out in the ICUs of Damanhur Medical National Institute.
A convenience sample of 60 critical care nurses who were involved in providing direct patient care and willing to participate in the study
To accomplish the aim of the current study; one tool was used for data collection ‘critical care nurses hand antisepsis and hand washing practices observational checklist’ which included three parts. Part I covered nurses’ characteristics including; age, sex, academic degree and job related data such as work place, job title and experience. The second part was used to record items regarding hand washing with soap and water and hand antisepsis with sterillium techniques. The third part was used to record microbiological findings.
Data collected as the following:
For both groups, the nurses’ characteristics were recorded in part one of the study tool.
- Each nurse from the both groups performed hand washing with soap and water before starting the nursing intervention and each nurse was observed using part II of the study tool
- After performing the nursing intervention, an imprint of both hands (palms and fingertips) of each nurse was taken before performing the hand washing with soap and water or hand antisepsis with strellium
For the control group: after taking the first imprint that was taken after performing nursing care procedures, each nurse performed hand washing with soap and water, each nurse was observed during the technique of hand washing with soap and water using part II of the study tool.
- An imprint was taken from both hands (palms and fingertips) of each nurse for the bacteriological culture immediately after performing the hand washing with soap and water.
For the intervention group: after taking the first imprint that was taken after performing nursing care procedures, each nurse performed hand antisepsis with strellium, and observed during the technique of hand antisepsis and then the data recorded using part II of the study tool.
- Then an imprint was taken from both hands (palms and fingertips) of each nurse for the bacteriological culture immediately after hand antisepsis procedure.
Results:
The current study findings indicated no statistical significant difference between the two groups regarding the nurses’ characteristics. While there was a highly statistical significant difference between the control and intervention group before and after nursing intervention. The total mean score percent of the majority of the nurses in the intervention group was high in the hand hygiene practice before the nursing intervention and it was high in all the nurses in the intervention group after the nursing intervention.
The majority of the studied nurses’ imprints in the control group had microbial growth on their palms and fingertips after performing hand washing with soap and water. While, most of the studied nurses’ imprints in the intervention group had no or very little growth of the microorganisms on their palms and fingertips after performing hand antisepsis with strellium.
The number of bacteria was significantly reduced on the studied nurses’ palms and fingertips after hand antisepsis with strellium than routine hand washing with soap and water. Moreover, the most common isolated bacteria in the intervention and control groups were coagulase negative staphylococcus followed by staphaureus and other gram negative bacteria (Aceintobacter, klebseilla, Enterobacteraggl, and Enterobactercloacae)
Conclusion: from the current study findings it can be concluded that:
- The majority of the studied nurses’ imprints in the intervention group had no or little microbial growth after performing hand antisepsis with strellium, while the majority of the studied nurses’ imprints in the control group had microbial growth after performing routine hand washing with soap and water with highly statistical difference between the control and intervention groups.
- Bacterial reduction on the nurses’ palms and fingertips after hand antisepsis with sterillium in the intervention group was higher than the routine hand washing with soap and water in the control group with highly statistical difference between the control and intervention groups.
Recommendations: from the current study findings the following recommendations are suggested:
• Conducting regular staff meetings for the discussion of the work related problems and to solve the different obstacles.
• Utilizing the hand hygiene by using the hand washing with soap and water followed by hand antisepsis with strellium when visible hand contamination.
• Focusing on the importance of hand hygiene with using strellium for hand antisepsis.
• Performing the appropriate hand hygiene technique before and after each patient’s contact.
• Conducting regular checkup of the hands of the CCNs to identify bacterial colonization.
• Implementing educational programs about guidelines, and techniques of hand hygiene to the nurses to update their knowledge and to demonstrate the basic practices.
• Developing system for periodical nurses’ evaluation to determine strategies for updating their knowledge and enhancing their practice.
• For generalization replication of this study is recommended for a larger study sample and in multi settings.