Easy 3-step hand rub technique superior to 6-step technique: Study

A shortened 15-second application time and an easy three-step technique for use of alcohol-based hand rub is as effective in reducing bacteria as the 30-second application and six-step technique recommended by World Health Organization(WHO), new research says.

The research, which is being presented at this year's 'European Congress of Clinical Microbiology & Infectious Diseases' (ECCMID), claimed that the new technique could also improve hand hygiene compliance.

Hand hygiene is the single most effective thing healthcare workers can do to reduce the spread of infectious diseases, but there is limited evidence on which technique is most effective.

WHO recommends a six-step 'how to hand rub' technique for using alcohol-based hand rub. However, adherence to all six steps is low and previous research indicates that a simplified three-step hand rub technique is superior to the six-step technique in terms of compliance and killing bacteria.

In this research, Dr Sarah Tschudin-Sutter and his colleagues investigated combining the simpler three-step technique with a shorter application time of 15 seconds.

20 healthy volunteers (aged 18 to 51 years) were randomly assigned to rub their hands by following four different techniques - the six-step hand hygiene technique for 30 seconds; the six-step hand hygiene technique for 15 seconds; the three-step hand hygiene technique for 30 seconds; and the three-step hand hygiene technique for 15 seconds.

Results showed that a shorter application time of 15-second rub was as effective at reducing bacterial counts on the hands of participants as the recommended 30-second hand rub.

"The time pressure and heavy workload experienced by healthcare workers reduce compliance with hand hygiene standards. Our findings suggest that shortening hand rubbing time and simplifying the technique for use of hand rub could be a safe alternative that is easier to fit into their busy routine, could enhance the overall quality of hand hygiene performance, and have a positive effect on adherence", said Professor Tschudin-Sutter.

"Further studies are needed to validate the performance of the shorter application time in everyday clinical practice," he added.

The authors pointed to several limitations and the most important is that the study assesses the efficacy of the two different hand hygiene techniques and two different application times in an experimental setting. So, the results cannot be extrapolated to a clinical setting.

They also noted that they measured the reduction of bacterial counts. Therefore, conclusions cannot be made about the impact of different hand hygiene techniques on the transmission of pathogens.