How to compare handrub techniques?
Many techniques exist how to handrub, most of
them are based on the
so-calles WHO 6-step protocol. As we
previously summarized, this has limitations; it takes long to
perform, quite hard to remember and therefore its compliance is pretty low. For
these reasons, several
alternative protocols exist, but we have limited data on the efficacy
of these alternatives.
In our study, we compared the 6-step protocol
with one of the most promising alternative technique, the 3-step protocol suggested
by Tschudin-Sutter et al. 2017.
This preserves the last two steps of the 6-steps protocol, that are focusing on
thumbs and fingernails. As a first step, it only requires to “cover all
surfaces of the hands”. Tschudin-Sutter et al. 2017
compared the two protocols by measuring the bacterial reduction factors
achieved, and found that the simplified 3-steps method was even more efficient.
A shorter protocol can make hand hygiene education more effective and also can
result in improved compliance.
In our study, we measured the hand hygiene
performance with the Semmelweis
Scanner. Using 1.5 ml handrub, volunteer non-clinician participants
were asked to precisely follow one of the protocols. Percentage of
handrub-covered hand surface was determined.
211 hand hygiene events were recorded (3-step:
n=103, 6-step, n=108). No significant difference was found between the
efficacies of the protocols. Participants who performed the 6-step protocol
covered 91 ± 11 % of their hands (mean ± standard deviation). Applying the
alternative, 3-step protocol, coverage was almost the same, 93 ± 9 %.
Our study had several limitations, and
definitely requires further evaluation.
Our method is able to measure handrub-covered
hand surfaces, and thus, it is a suitable method to compare the efficacies of
different protocols. This method is relatively quick and cost effective,
allowing to handle large sample size.
View our poster
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