¶ … United States or Europe but there are a few outliers. First off, Sharma et al. (2013) is written from an Indian perspective. Further, Salmon et al. (2014) directly references Vietnamese hospitals but is written in a clearly labeled American journal while Zaragoza et al. (1999) and its study was set in Barcelona. Girou et al. (2002) appears in a British journal. Zaragoza et al. is in an American Journal. The basic comparison that is prevalent in all of the journal articles at one level or another is the comparison in results and cleanliness between traditional soap scrub downs and alcohol-based solutions being used in those same scrubbing sessions. The comparisons being made were based on the efficacy of the hand-washing solution, the time it took to do each washing solution and so forth. For example, Chow et al. (2012) looked at both. It actually compared three protocols in total, those being alcohol-based solutions, seven-step process alcohol rubdowns and chlorhexidine solutions. It was found that alcohol was just as effective as chlorhexidine but that the alcohol solution was quicker. The Eksi (2010) study found a different performance based on the ward that the hand-washing occurred in and they also noted that rubbing enhanced the performance of hand-washing. The Girou et al. (2002) study mirrored the Chow study in that it found greater efficacy in hand-rubbing. The McNeil et al. (2001) study looked at people with artificial nails. Since a lot of nurses are women, this was a good thing to look at. A detail that Salmon et al. (2014) looked at was the dominant hand vs. The non-dominant hand. The Sharma et al. (2013) study was like the Chow one in that it covered and compared three different methods but it was otherwise basically the same as Chow. Integration/Synthesis -- Three Articles

One of the studies being drilled down on was that of Chen (2012) and it...

The results were tabulated over 48 hours. There was only one hundred people actually assessed but they were randomly picked from medical centers in Taiwan. The study was done over two days in July 2010. Their overall findings were that waterless hand scrubbing was just as effective as regular hand-scrubbing and that the waterless solution took less time than the traditional hand-scrubbing. Even so, there were fifty samples taken and seven of those samples had active bacteria on them. A total of nine surgical patients were found to have had some sort of contact with the fourteen participants that themselves had microorganisms on their bodies (Chen et al., 2012). The Parienti (2002) study was set in France and was different in that while it compared two different methods of hand-washing, they looked at infection rates over a thirty day period. Their sample size was also much bigger than most if not all of the studies in this report. Indeed, the study looked at six different surgical sites across all of France. The patient count involved was more than four thousand and these patients were treated over a span of more than a year as the study ran from January 2000 to May 2001. The study found that a one-minute non-antiseptic wash coupled with an alcohol wash was just as effective as traditional hand-washing that utilized anti-septic soap (Parienti et al., 2002). The final study to be looked at also occurred over a time frame of more than a year. However, the number of participants was a little lower. About 128 health workers were look at in the Shen et al. (2013) journal article. There was a comparison between an alcohol-based hand rub or the more conventional "surgical scrub." Hand cultures were done before and after scrub-down to compare the presence of bacterial both with and without the sterilization efforts.…