The impact of hand hygiene technique on hand hygiene compliance and microbiological efficacy

• Register: ISRCTN
• Last refreshed on: 29 June 2020
• Main ID: ISRCTN45923734
• Date of registration: 09/05/2018
• Prospective Registration: No
• Primary sponsor: Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel
• Public title: The impact of hand hygiene technique on hand hygiene compliance and microbiological efficacy
• Scientific title: Simplifying the WHO protocol: Three steps versus six steps for performance of hand hygiene - a cluster-randomized trial
• Date of first enrolment: 01/10/2015
• Target sample size: 274
• Recruitment status: Completed
• URL: http://isrctn.com/ISRCTN45923734
• Study type: Interventional
• Study design: Cluster-randomised trial (Prevention)
• Phase: Not Applicable

Countries of recruitment

Switzerland

Contacts

• Name: Sarah Tschudin Sutter

Key inclusion & exclusion criteria

Inclusion criteria: All handhygiene actions performed on included wards were eligible for inclusion.
Exclusion criteria: Bacterial count (measured in number of colony forming units) prior to hand rub use was less than a mean of 5log CFU.

Age minimum:
Age maximum:
Gender: Both

Health Condition(s) or Problem(s) studied

Prevention of healthcare-associated infections and transmission of pathogens in healthcare settings.
Infections and Infestations
Healthcare associated infections

Intervention(s)

Twelve wards are randomly assigned to either the 3-step technique or the conventional 6-step technique for use of hand rub.
The following two hand hygiene techniques outlining the steps for application of hand rub are compared in this trial:
The 6-step technique as recommended by the WHO (Organization WHO. WHO Guidelines on Hand Hygiene in Health Care, First Global Patient Safety Challenge Clean Care is Safer Care 2009) and the 3-step technique as previously reported (Tschudin-Sutter S, Rotter ML, Frei R, et al. Simplifying the WHO 'how to hand rub' technique: three steps are as effective as six-results from an experimental randomized crossover trial. Clin Microbiol Infect 2017).
The 3-step technique consists of: (1) covering all surfaces of the hands (based on own judgement), (2) rotational rubbing of fingertips in the palm of the alternate hand, and (3), rotational rubbing of both thumbs.
The 6-step technique: (1) rubbing hands palm to palm, (2) palm to palm with fingers interlaced, (3) right palm over left dorsum with interlaced fingers and vice versa, (4) back of fingers to opposing palms with fingers interlocked, (5) rotational rubbing of left thumb clasped in right palm and vice versa, and (6) rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa.
Both techniques are performed for 30 seconds using three ml of hand rub.
Educational activities outlining the importance of hand hygiene, compliance to the five hand hygiene indications as outlined by the WHO and technique are provided to all participating wards. These consist of tutorials taught by experienced infection control nurses prior to trial initiat

Primary Outcome(s)

1. Compliance with the assigned technique is assessed using direct observations by four trained observers using an electronic case report form at random throughout the study period
2. Bacterial counts on hands of healthcare workers are measured using EN 1500 bacterial count assessment, at random throughout their routine daily activities in the study period

Secondary Outcome(s)

Compliance with the five hand hygiene indications as outlined by the WHO is assessed using direct hand hygiene observations by four trained observers using an electronic case report form throughout the study period

Secondary ID(s)

Handhygiene10/2015

Source(s) of Monetary Support

Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel

Results

• Results available: Yes
• Date Completed: 31/12/2017