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Alcohol hand-rub drunk on wards

30/11/2007

Hospitals and care homes should place large hand-rub dispensers in locked secure holders to prevent people from ingesting them, medics have warned today.

They say the liquid should not be accessible so that it cannot be consumed either intentionally or accidentally by the young, confused or alcohol-dependent.

The warning follows an increase in the number of incidents where patients have ingested the hand-rub since its use increased in hospitals.

In 2005 new recommendations said the hand-rub should be placed at the entrances to wards and by bedsides to help improve hospital hygiene and reduce the risk of healthcare-associated infections such as MRSA and Clostridium difficile.

Toxicologists at Guy's and St Thomas' NHS foundation trust poisons unit compared the number of enquiries to their centre in London from other health professionals during the 16-month periods either side of the hand-rubs' widespread introduction.

These enquiries related to both adults' and children's exposure to the rub, including ingestion and eye exposure.

Their study revealed an increase in the total number of enquiries to the unit - 23 were recorded before hand-rubs became widespread compared to 50 afterwards.

There was also a marked increase in the number of adults ingesting the liquid: 29 compared to seven before 2005. Nineteen of these cases were thought to be due to intentional ingestion.

"Poisoning from alcohol hand-rub remains relatively uncommon but has increased since widespread introduction of the hand rubs in the UK," the researchers write in the British Medical Journal.

They say that in patient areas where hand-rubs are easily accessible by those thought to be at high risk of ingestion, the liquid should be "placed within locked, secured holders"

"[The] potential for toxicity presents a major challenge to patients' safety and to risk management, which needs a multidisciplinary and coordinated approach from risk managers, toxicologists, and infection control specialists," the study's authors conclude.