This can be for a number of reasons, both problems in use or for religious and cultural reasons.
We already know the WHO has issued a directive that an alternative to ABHR's should be made available to those who will not use ABHR's on religious or cultural grounds.
Well buried deep in the WHO Guidelines on Hand Hygiene in Health Care: A Summary First Global Patient Safety Challenge Clean Care is Safer Care, © World Health Organization 2009, is the following;
"Provide alternative hand hygiene products for HCW's with confirmed allergies or adverse reactions to standard products used in the health-care setting".
We know that adverse reactions is one of the main areas reported as to why HCW's do not comply with Hand Hygiene protocols, but many decision makers will not change from ABHR's due to what is after all only a recommendation from the WHO (and CDC).
As we can see from the statement above, that there is not a real reason not to change.
Yes Ebiox would be delighted to convert totally a healthcare institution, but more importantly we have been striving to have Esense Hand Foam readily available to those who have issues with using ABHR's, therefore driving up compliance levels which ensures greater Duty of Care and safety to patients and staff.