Questions About PD
We thank you for your question. Last October, to answer another question, we conducted a small survey of members of our ISPD Nursing Committee (Australia, Brazil, Canada, New Zealand, the U.K. and the U.S) and found that practices on teaching hand hygiene to patients on PD do vary, country to country: some recommended washing with soap (usually any brand of liquid soap followed by drying with disposable paper towels, one did recommend liquid anti-bacterial soap); one recommended solely alcohol-based hand sanitizer; two (Canada and the U.K.) recommended initially using liquid hand soap on gathering supplies and setting up for PD, then use of alcohol-based hand sanitizer immediately before connecting. If the home PD patient was on automated peritoneal dialysis (APD) and using a drain line draining into a toilet, then particular attention was paid to teaching the PD patient to repeat hand hygiene after touching the toilet. This is a whole area that would certainly benefit from further research.
This US Centers for Disease Control and Prevention does provide detailed advice for hand hygiene in the community, recommending soap and water for hand washing over hand sanitizer not only when hands are visibly soiled, but also for example before and after preparing food, touching animal waste, or touching garbage (1).
Also, be aware that alcohol-based hand sanitizers are not as effective as soap and water in removing certain spores such as Clostridioides difficile (C. diff), mostly of concern if there is a C. diff outbreak on a hospital ward, when soap and water for handwashing is preferred (1,2).
1.Centers for Disease Control and Prevention (CDC). Hand Sanitizer Use Out and About. Updated: August 10, 2021. https://www.cdc.gov/handwashing/hand-sanitizer-use.html#:~:text=Hand%20sanitizers%20also%20may%20not,and%20heavy%20metals%20like%20lead.
2.Doll M, Marra AR, Apisarnthanarak A, Al-Maani AS, Abbas S, Rosenthal VD. Prevention of Clostridioides difficile in hospitals: A position paper of the International Society for Infectious Diseases. International Journal of Infectious Diseases. 2021 Jan 1;102:188-95.Available at: