Hand disinfection in inpatient geriatric care: Superiority study in a parallel group design of cold plasma aerosol versus alcohol-based disinfection methods

Abstract

Background In the 19th century, basic hygiene measures were introduced in the healthcare sector, which reduced mortality rates. Modern advances such as alcohol-based sanitizers have improved hand hygiene, although it often becomes neglected in nursing facilities. Studies show low staff compliance rates, leading to high cross-infection rates. New approaches such as cold plasma hand disinfection could offer promising alternatives by minimizing skin damage and offering economic benefits. The current investigation aims to comparatively assess the disinfectant efficacy of the cold plasma aerosol under practical application conditions, in comparison with an alcoholic hand disinfectant listed in the Association for Applied Hygiene list. Methods The microbial density on the participants' hands was measured, and the spontaneous occurrence of fecal indicators and the presence of potentially infectious bacteria were also investigated. A t-test for independent samples was performed to test whether the two cohorts differed significantly from each other regarding the research question. Results Statistical analysis showed that the mean log colony forming unit values were significantly lower in the test cohort using only the cold plasma method for hand disinfection than in the cohort using only conventional alcohol-based hand disinfection. Furthermore, it could be shown that, in contrast to alcohol-based hand disinfection, cold plasma application ensures effective elimination of Staphylococcus aureus. Discussion The results show that staff using plasma disinfection have an average bacterial density that is 0.65 log units lower than the bacterial density on hands with regular use of alcohol-based hand disinfection. In addition to the effectiveness of cold plasma disinfection, superiority over alcohol-based hand disinfection was also demonstrated. In addition to economic and logistical benefits, cold plasma disinfection also offers added health benefits as, unlike alcohol-based hand disinfection, it does not cause any damage to the skin.