Assessment of the appropriateness of hand surface coverage for health care workers according to World Health Organization hand hygiene guidelines

Park, Hee-Youn; Kim, Sun-Kyung; Lim, Young‐Ju; Kwak, Sun Hee; Hong, Min-Jee; Mun, Hyang-Mi; Park, So‐Yeon; Kim, Hyeon-Jeong; Choi, Hyung Soon; Jeong, Jae-Sim; Kim, Mina; Choi, Sang‐Ho

doi:10.1016/j.ajic.2013.12.014

Cited by 35 publications

(36 citation statements)

References 6 publications

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“…Our observations identified that step 5 (rotational rubbing of the left thumb clasped in the right palm and vice versa) had the lowest compliance and that there was better overall compliance in nurses. Park HY et al [4] report better compliance in nurses (90.5%) but without differences in hand surface coverage between nurses (8.3%) and doctors (8.8%) and lower compliance rates for other healthcare professionals.…”

Section: Discussionmentioning

confidence: 96%

Assessment of hand hygiene techniques using the World Health Organization's six steps

Arias

Garcell

Ochoa

et al. 2016

Journal of Infection and Public Health

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The quality of hand hygiene was evaluated via direct observation for compliance with the six recommended World Health Organization steps. A total of 2497 HH opportunities, of which 1573 (63.0%) were hand rubs, were monitored over a five month period. Compliance was higher in nurses compared with physicians and auxiliaries and in steps 1 and 2 for hand rubs as well as the first three steps of hand washing, with lower rates after these steps. Rubbing of the thumbs and fingertips achieved the lowest rates of compliance in both HH types. A combination of the five recommended moments and six steps and staff education is recommended to improve the quality of hand hygiene.

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Section: Discussionmentioning

confidence: 96%

Assessment of hand hygiene techniques using the World Health Organization's six steps

Arias

Garcell

Ochoa

et al. 2016

Journal of Infection and Public Health

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show abstract

“…A recent Korean study that directly observed compliance and completion of individual HH steps reported a high CR (86.7%); however, while almost all of the subjects applied the correct technique to disinfect the palm and dorsum, only 60% paid attention to the areas between fingers, and only 10% rubbed the thumbs and finger tips. 5 This study focused exclusively on HH technique, with the aim of improving the quality of healthcare workers' (HCW) hand hygiene technique through personalized, objective feedback using the innovative Hand-in-Scan device (HandInScan Ltd, Debrecen, Hungary).…”

Section: Introductionmentioning

confidence: 99%

Quantitative impact of direct, personal feedback on hand hygiene technique

Lehotsky¹,

Szilágyi²,

Ferenci³

et al. 2015

Journal of Hospital Infection

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“…5,[8][9][10][11][12] In these studies, compliance with the technique varied from 7.9% 5 to 8.5% 13 to 31% 14 to 47%. 12 Our study found that even during figure 1. The percentage of participants in the 6-step (60 observations) and 3-step (59 observations) arms who were compliant with the specific components of the hand hygiene techniques.…”

Section: -10mentioning

confidence: 99%

A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom

Reilly

Price

Lang

et al. 2016

Infect. Control Hosp. Epidemiol.

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objective. To evaluate the microbiologic effectiveness of the World Health Organization's 6-step and the Centers for Disease Control and Prevention's 3-step hand hygiene techniques using alcohol-based handrub.design. A parallel group randomized controlled trial.setting. An acute care inner-city teaching hospital (Glasgow).participants. Doctors (n = 42) and nurses (n = 78) undertaking direct patient care.intervention. Random 1:1 allocation of the 6-step (n = 60) or the 3-step (n = 60) technique.results. The 6-step technique was microbiologically more effective at reducing the median log 10 bacterial count. The 6-step technique reduced the count from 3.28 CFU/mL (95% CI, 3.11-3.38 CFU/mL) to 2.58 CFU/mL (2.08-2.93 CFU/mL), whereas the 3-step reduced it from 3.08 CFU/mL (2.977-3.27 CFU/mL) to 2.88 CFU/mL (−2.58 to 3.15 CFU/mL) (P = .02). However, the 6-step technique did not increase the total hand coverage area (98.8% vs 99.0%, P = .15) and required 15% (95% CI, 6%-24%) more time (42.50 seconds vs 35.0 seconds, P = .002). Total hand coverage was not related to the reduction in bacterial count.conclusions. Two techniques for hand hygiene using alcohol-based handrub are promoted in international guidance, the 6-step by the World Health Organization and 3-step by the Centers for Disease Control and Prevention. The study provides the first evidence in a randomized controlled trial that the 6-step technique is superior, thus these international guidance documents should consider this evidence, as should healthcare organizations using the 3-step technique in practice. 2016;37:661-666 Hand hygiene is argued to be the most important intervention in preventing healthcare-associated infection. Infect Control Hosp Epidemiol1 Despite this, a recent systematic review 2 identified that there is limited evidence to support hand hygiene techniques, and compliance with hand hygiene remains suboptimal. There is little point in getting the opportunity, or the "5 Moments," 1 correct for hand hygiene if a technique effective in reducing the bacterial load on the hand thereafter is not evident.There are 2 main techniques in international guidance on hand hygiene: the first of these is the World Health Organization 6-step technique, 1 which involves applying a palmful of alcohol-based handrub (ABHR) in a cupped hand, covering all surfaces, and rubbing 6 different aspects of the hands. This technique has a limited evidence base for use in clinical practice because it was developed as a standardized technique to test hand hygiene products in a laboratory setting.3 Furthermore, this technique has no evidence of microbiologic effectiveness in clinical settings with ABHR. The second technique is the 3-step technique. This technique involves first, applying ABHR to the palm of one hand and rubbing hands together; second, covering all surfaces; third, continuing to rub until hands are dry. 4 There is some observational evidence base 5 and 1 randomized controlled trial (RCT) to support this technique on the basis of shorter duration, althoug...

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Assessment of the appropriateness of hand surface coverage for health care workers according to World Health Organization hand hygiene guidelines

Cited by 35 publications

References 6 publications

Assessment of hand hygiene techniques using the World Health Organization's six steps

Assessment of hand hygiene techniques using the World Health Organization's six steps

Quantitative impact of direct, personal feedback on hand hygiene technique

A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom

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