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Six-step hand-washing technique found most effective for reducing bacteria

April 08, 2016

New research demonstrates that the six-step hand-hygiene technique recommended by the World Health Organization is superior to a three-step method suggested by the U.S. Centers for Disease Control and Prevention (CDC) in reducing bacteria on healthcare workers' hands. The study was published online today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

"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," said Jacqui Reilly, PhD, lead author of the study and professor of infection prevention and control at Glasgow Caledonian University in Scotland. "This study provides a foundation for effective best practices to implement on the frontlines of healthcare."

During the randomized controlled trial in an urban, acute-care teaching hospital, researchers observed 42 physicians and 78 nurses completing hand-washing using an alcohol-based hand rub after delivering patient care. The six-step technique was determined to be microbiologically more effective for reducing the median bacterial count (3.28 to 2.58) compared to the three-step method (3.08 to 2.88). However, using the six-step method required 25 percent more time to complete (42.50 seconds vs. 35 seconds).

"One of the interesting incidental findings was that compliance with the six-step technique was lacking. Only 65 percent of providers completed the entire hand hygiene process despite participants having instructions on the technique in front of them and having their technique observed. This warrants further investigation for this particular technique and how compliance rates can be improved," said Reilly.

The researchers recommend authors of international guidance should consider this evidence when making official recommendations on best practices in hand hygiene.
-end-
Jacqui Reilly, Leslie Price, Sue Lang, Chris Robertson, Francine Cheater, Kirsty Skinner, Angela Chow. "A pragmatic randomised controlled trial of 6 step versus 3 step Hand Hygiene technique in acute hospital care." Web (March 31, 2016).

About ICHE

Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13th out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.

SHEA is a professional society representing physicians and other healthcare professionals around the world with expertise and passion in healthcare epidemiology, infection prevention, and antimicrobial stewardship. SHEA's mission is to prevent and control healthcare-associated infections, improve the use of antibiotics in healthcare settings, and advance the field of healthcare epidemiology. SHEA improves patient care and healthcare worker safety in all healthcare settings through the critical contributions of healthcare epidemiology and improved antibiotic use. The society leads this specialty by promoting science and research, advocating for effective policies, providing high-quality education and training, and developing appropriate guidelines and guidance in practice. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.

About Cambridge Journals

Cambridge University Press publishes over 350 peer-reviewed academic journals across a wide spread of subject areas, in print and online. Many of these journals are leading academic publications in their fields and together form one of the most valuable and comprehensive bodies of research available today.

For further information about Cambridge Journals, visit journals.cambridge.org.

About Cambridge University Press

Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence.

Its extensive peer-reviewed publishing lists comprise 45,000 titles covering academic research, professional development, over 350 research journals, school-level education, English language teaching and bible publishing.

Playing a leading role in today's international market place, Cambridge University Press has more than 50 offices around the globe, and it distributes its products to nearly every country in the world.

For further information about Cambridge University Press, visit cambridge.org.

Society for Healthcare Epidemiology of America

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