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Simpler hand-rub application as effective as WHO's

Monday April 15th, 2019

A three-step, 15-second technique for applying hand rub is as good at preventing infection as the more protracted WHO-recommended technique, a European conference has been told.

Researchers compared the WHO technique, which recommends a six-step 'how to hand rub' technique for using alcohol-based hand rub, with a simplified three-step hand rub technique. The latter was just as effective, they report.

Results from the randomised cross-over trial conducted by Professor Sarah Tschudin-Sutter and colleagues from University Hospital Basel, Switzerland, are being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Netherlands.

The study involved 20 healthy volunteers, aged 18 to 51 years, who were randomly assigned to rub their hands by following four different techniques: the six-step hand hygiene technique for 30 seconds; the six-step hand hygiene technique for 15 seconds; the three-step hand hygiene technique for 30 seconds; and the three-step hand hygiene technique for 15 seconds.

Researchers found that the 15-second hand rub technique was as effective at reducing bacterial counts on the hands of participants compared to the recommended 30-second hand rub, irrespective of the hand hygiene technique.

"The time pressure and heavy workload experienced by healthcare workers reduces compliance with hand hygiene standards,” said Professor Tschudin-Sutter.

“Our findings suggest that shortening hand rubbing time and simplifying the technique for use of hand rub could be a safe alternative that is easier to fit into their busy routine, could enhance the overall quality of hand hygiene performance, and have a positive effect on adherence.”

The authors admit there are limitations to the study and call for more research to be conducted.

* Delegates at the conference will also hear about a USA-based study, which showed that healthcare workers may forget to clean their hands when moving from dirtier to cleaner tasks, increasing risk of transmitting infections to patients.

Professor Loreen Herwaldt from Roy J. and Lucille A. Carver College of Medicine, Iowa City, and colleagues analysed data from the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) study, involving a total of 3246 hours of observation between December 2005 and August 2006 in ICUs in 18 centres across the USA.

Results showed that general compliance with hand hygiene was poor - with physicians being 50% more likely than nurses to move from dirtier to cleaner tasks, and that hand hygiene was less likely when gloves were worn, with healthcare workers more likely to move from dirtier to cleaner tasks when they used gloves.

Healthcare workers performed proper hand hygiene in just half the instances when moving from dirtier to cleaner tasks, and only about 43% of the instances when moving from cleaner to dirtier tasks.

Tags: Europe | MRSA & Hygiene

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