Evidence-based hand hygiene: Volume Optimization for alcohol-based handrubs
Bánsághi Száva
Health Sciences
Dr. Nagy Zoltán Zsolt
SE Belgyógyászati és Onkológiai Klinika, Simonyi terem
2026-08-13 14:00:00
Clinical and comparative health sciences
Dr. Nagy Zoltán Zsolt
Dr. Haidegger Tamás
Dr. Kóbori László
Fülöpné Dr. Bohár Zsuzsanna
Dr. Wéber György
Dr. Oroszi Beatrix
Dr. Alexandra Peters
Hand hygiene is the most effective measure to prevent healthcare-associated infections. Although the use of alcohol-based handrubs has become the global standard, the optimal application volume has not yet been clearly defined. Current guidelines recommend application a “palmful” of product, acknowledging that the required volume varies with hand size. The aim of this work was to estimate the optimal ABHR volume for effective hand hygiene and to identify the factors influencing it.
Our studies demonstrated that ABHR volume plays a crucial role in hand hygiene performance. Using only 1 ml product left approximately 7 % of hand surfaces uncovered, while 3 ml reduced the uncovered area to around 1 %. However, increasing the volume caused excessive spillage and prolonged drying times, often exceeding 40 seconds, which may discourage compliance. Hand size was found to significantly affect both coverage and drying time. Therefore, to determine optimal dose for any individual, I propose using the concept relative ABHR volume, calculated as the applied volume divided by the total hand surface area. For medium-sized hands 3 ml corresponds to approximately 4 µl/cm², which appears to be an optimal balance between efficacy, spillage, and drying time, ultimately supporting better compliance and reducing product waste. Skin temperature, hydration level, and ABHR formats (liquid, gel, or foam) also influenced both coverage and drying time.
Applying personalized, relative ABHR dosages in the clinical practice would undoubtedly be beneficial. This could be achieved through smart dispensers capable of identifying users (e.g., via RFID) and delivering customized volumes. Such technology represents a promising step toward the personalized, data-driven hand hygiene of the future.
