OMAHA, Neb. — Doctors and nurses on the go often skip soap and water in favor of an alcohol-based hand gel, thinking the quick-acting goo will kill bacteria and curb the spread of infection.

It turns out that’s not enough. A study appearing in the January issue of Infection Control and Hospital Epidemiology found that in a Nebraska hospital, medical employees nearly doubled their use of the alcohol-based gel, but their generally cleaner hands had no bearing on the rate of infections among patients.

An infectious disease specialist at the University of Nebraska Medical Center, Dr. Mark Rupp, who led the study pointed to many villains: Rings and fingernails that are too long and hard to clean, poor handling of catheters, and treatment areas that aren’t sanitized. “There are many factors that influence the development of hospital-acquired infections. It would be naive to think that a single, simple intervention would fix this problem,” Dr. Rupp said.

The results appear to contradict guidelines from the Centers for Disease Control and Prevention.