Shortened Hand Hygiene Technique Could Improve Compliance

A simple three-step technique when applying an alcohol-based hand rub could improve hand hygiene compliance, according to a new study.

Researchers at University Hospital Basel (Switzerland) conducted a randomized cross-over trial involving 20 healthy volunteers (18-51 years of age) in order to examine if a shortened, 15-second application time and a simpler three-step technique for use of alcohol-based hand rub is as effective in reducing bacteria as the standard 30-second application/ six-step technique recommended by the World Health Organization (WHO, Geneva, Switzerland), and could improve hand hygiene compliance.


Study participants were assigned to rub their hands using four different techniques: the six-step hand hygiene technique for 30 seconds; the six-step technique for 15 seconds; the three-step hand hygiene technique for 30 seconds; and the three-step technique for 15 seconds. The results revealed that the 15-second rub was as effective at reducing bacterial counts as the 30-second hand rub, irrespective of hand hygiene technique. The study was presented at the annual European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) conference, held during April 2019 in Amsterdam (The Netherlands).

“The time pressure and heavy workload experienced by healthcare workers reduces compliance with hand hygiene standards. Our findings suggest that shortening hand rubbing time and simplifying the technique for use of hand rub could be easier to fit into their busy routine, could enhance the overall quality of hand hygiene performance, and have a positive effect on adherence,” said lead author and study presenter Professor Sarah Tschudin-Sutter, MD, and colleagues. “Further studies are needed to validate the performance of the shorter application time in everyday clinical practice.”

The WHO six steps to handwashing involve rubbing wet, soapy hands together, palm to palm; rubbing the back of each hand with the palm of the opposite hand; rubbing palm to palm while interlacing the fingers of each hand; rubbing the back of the fingers using opposing palms with the fingers locked; rubbing around each thumb with the palm of the opposing palm; and finally rubbing the palm of each hand with the fingers of the opposing hand.

Related Links:
University Hospital Basel
World Health Organization