Doctors and nurses often use a squeeze of alcohol-based hand sanitizer as a fast fix for killing germs, but researchers say skipping soap and water in favor of the gel might not be enough to reduce the threat of infection.

When medical workers at a Nebraska hospital doubled their use of antibacterial hand gels, researchers found the rate of hospital-acquired infections remained the same.

According to at the University of Nebraska Medical Center, bacteria-laden hands might not be the only cause of these infections. Other culprits include long fingernails and rings that are hard to clean, poor handling of catheters and treatment areas that aren’t sanitized.

Hospital-acquired infections are a growing health concern among medical professionals and patients. According to the Centers for Disease Control and Prevention, about one-point-seven-million cases occur in the U-S each year, resulting in nearly one-hundred-thousand deaths annually. These infections include drug-resistant staph, urinary tract infections and ventilator-associated pneumonia.

Researchers observed medical workers for three-hundred hours in two intensive care units. Bacteria samples were taken from health workers’ hands every sixty days during the two-year study.

But the findings shouldn’t cause health-care workers to shun sanitizing gels. The researchers still advise using them as part of an overall facility hygiene plan.

The key is to combine the use of gels with better cleaning of hospital units, proper insertion and maintenance of catheters and prescribing antibiotics only when necessary… steps that together improve efforts to combat infection-causing bacteria.