A six-step hand-washing technique advocated by the World Health Organization has been found to be the most effective for reducing bacteria.
Scottish researchers compared the WHO’s technique with a three-step method suggested by the US Centers for Disease Control and Prevention.
“This study provides a foundation for effective best practices to implement on the frontlines of healthcare”
The findings demonstrated that the six-step technique was superior to the three-step method in reducing bacteria on the hands of healthcare workers in a Glasgow teaching hospital.
The researchers observed 42 doctors and 78 nurses completing hand-washing using an alcohol-based hand rub, after providing patient care.
The six-step technique was determined to be microbiologically more effective for reducing the median bacterial count.
It reduced the bacterial count from 3.28 CFU/mL to 2.58 CFU/mL. This was compared to the three-step method, which reduced the count from 3.08 CFU/mL to 2.88 CFU/mL.
However, using the six-step method required 25% more time to complete – 42.50 seconds versus 35 seconds).
The researchers recommend that international guidance should consider their evidence when making official recommendations on best practices in hand hygiene.
“The study provides the first evidence in a randomised controlled trial that the six-step technique is superior, thus these international guidance documents should consider this evidence, as should healthcare organisations using the three-step technique in practice,” they said in the journal Infection Control and Hospital Epidemiology.
Six-step hand-washing technique ‘most effective’
Lead study author Jacqui Reilly, professor of infection prevention and control at Glasgow Caledonian University, said: “Hand hygiene is regarded as the most important intervention to reduce healthcare-associated infections, but there is limited evidence on which technique is most effective.”
She suggested that her findings provided a “foundation for effective best practices to implement on the frontlines of healthcare”.
She added: “One of the interesting incidental findings was that compliance with the six-step technique was lacking.
“Only 65% of providers completed the entire hand hygiene process despite participants having instructions on the technique in front of them and having their technique observed,” she said. “This warrants further investigation.”
6-Step: Applying a palmful of alcohol-based handrub (ABHR) in a cupped hand, covering all surfaces, and rubbing six different aspects of the hands
3-Step: Applying ABHR to the palm of one hand and rubbing hands together; second, covering all surfaces; third, continuing to rub until hands are dry