Attitudes and Knowledge of Thai Health Professionals and the General Public Toward Using 70% Isopropyl Alcohol Before Intradermal, Subcutaneous, and Intramuscular Injections/Vaccinations

Abstract

Introduction: Using 70% isopropyl alcohol for skin preparation before intradermal (ID), subcutaneous (SC), and intramuscular (IM) vaccinations/injections is a routine practice for all Thai medical personnel, yet there is no direct evidence it reduces infections. Many studies, including the WHO best practices for injections and related procedures toolkit 2010, state cleaning dirty skin with soap and water is sufficient. This study assessed the percentage of medical personnel familiar with this toolkit and their skin preparation attitudes and knowledge. WHO injection practices information was discussed. Patients and their relatives’ opinions were collected. Two cross-sectional questionnaires in 400 medical and 400 non-medical persons at Thammasat University Hospital January - February 2020 and April - June 2021.

Methods: One questionnaire was given to health professionals on their attitude, knowledge, and knowledge sources toward skin preparation; another was distributed to patients and relatives on attitudes about cleaning injection sites with soap and water.

Results: Only 19.0%, 19.0%, and 14.8% of medical personnel and 17.3%, 17.3%, and 17.8% of the general public agreed solely cleaning sites with soap and water was sufficient in ID, SC, and IM vaccinations/injections, respectively. Only 20.0% - 23.8% of medical personnel knew about the WHO toolkit; nonetheless, 52.0% - 55.8% said they would follow it.

Conclusions: Using alcohol as routine skin preparation lacks scientific evidence, potentially leading to skin irritation/allergies, wasting both time and money. Medical professionals require an introduction to WHO best practices for injections, and patients and their relatives require more education on using soap and water, as appropriate.