Hand hygiene, which refers to routine hand wash, antiseptic hand wash, antiseptic hand rub or surgical hand antisepsis, is universally acknowledged as a cornerstone of the prevention of health care-associated infections (HAIs). It is the simplest and most effective measure for preventing cross-transmission of microorganisms and reducing patient morbidity and mortality from HAIs. The impact of hand hygiene depends not only on the regularity and thoroughness of the procedures used but also on the type of hand-washing agent selected (WHO, 2009). For most routine activities, hand washing with plain soap is sufficient since soap will remove most transient microorganisms. Nevertheless, compliance with hand washing among health care workers (HCWs) is only about 40–50%, which is unacceptably low. This constant finding is disturbing because studies have shown that this level of compliance will not reduce the risk of transmission of multi-resistant bacteria in hospitals. (DePaola, et al., 2009, p. 28)
The most current guidelines from the World Health Organization (2009) indicate that use of alcohol based hands rubs is the preferred method of preventing hospital acquired infections. Research suggests that hand washing with plain soap and water can actually increase bacteria. The only appropriate time to use soap and water is if hands are visibly soiled or the patient is suspected or proven to have clostridium difficile.