S The SHoRT Study- 6 or 3 steps to effective hand decontamination

Lesley Price, Jacqui Reilly, Susan Lang, Christopher Robertson, Francine Cheater, Angela Chow, Sandra McNamee

Research output: Contribution to conferencePaper

Abstract

Background: Little evidence exists to support the recommended hand hygiene technique for the use of handrub in clinical practice.

Aim
To compare the effectiveness of 6 versus 3-step handrub technique in healthcare workers.

Method:
• Random allocation of 48 hospital based medical and 72 nursing staff to either:
o 1. Hand rubbing with alcohol based handrub covering all hand surfaces in no particular order (3-step technique)
o or
o 2. Hand rubbing with alcohol based handrub using the 6-step technique.
• Glove juice sample of the dominant hand pre and post-handrub.
• Observation of time for handrub. & the extent of hand coverage achieved.

Results:
• Ratios of total bacterial counts pre- and post-handrub (median 6-step 0.31 from a baseline median of 1900 cfu/ml median 3-step 0.65 from a baseline median of 1200 cfu/ml, p = 0.016) indicated a significantly larger reduction in bacterial loads using the 6-step technique.
• The time taken for handrub was 25% (95% CI: 6%-14%) more for the 6-step technique (p = 0.002).
• The area of the hand not covered did not differ significantly between the techniques (3-step 1.02%; 6-step 1.20%).
• The 6-step technique more frequently missed the back of hands (¿2=7.18 P=0.007 left hand; ¿2 =9.86 P=0.002 right hand).
• The 3-step technique more frequently missed the back of the index (¿2=6.71 P=0.01) and the middle finger (FET: P=0.002).

Conclusion: Whilst both techniques achieved good coverage of the hand surface, the 6-step technique was more effective at reducing the bacterial count than the 3-step, but was also more time consuming.
Original languageEnglish
Publication statusPublished - 2014

Fingerprint

Decontamination
Hand
Bacterial Load
2-Propanol
Hand Hygiene
Nursing Staff
Random Allocation
Fingers
Observation
Delivery of Health Care

Keywords

  • hand hygiene
  • spread of infection
  • health care staff
  • alcohol hand rub

Cite this

Price, L., Reilly, J., Lang, S., Robertson, C., Cheater, F., Chow, A., & McNamee, S. (2014). S The SHoRT Study- 6 or 3 steps to effective hand decontamination.
Price, Lesley ; Reilly, Jacqui ; Lang, Susan ; Robertson, Christopher ; Cheater, Francine ; Chow, Angela ; McNamee, Sandra. / S The SHoRT Study- 6 or 3 steps to effective hand decontamination.
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title = "S The SHoRT Study- 6 or 3 steps to effective hand decontamination",
abstract = "Background: Little evidence exists to support the recommended hand hygiene technique for the use of handrub in clinical practice.AimTo compare the effectiveness of 6 versus 3-step handrub technique in healthcare workers. Method:• Random allocation of 48 hospital based medical and 72 nursing staff to either: o 1. Hand rubbing with alcohol based handrub covering all hand surfaces in no particular order (3-step technique)o or o 2. Hand rubbing with alcohol based handrub using the 6-step technique. • Glove juice sample of the dominant hand pre and post-handrub.• Observation of time for handrub. & the extent of hand coverage achieved.Results: • Ratios of total bacterial counts pre- and post-handrub (median 6-step 0.31 from a baseline median of 1900 cfu/ml median 3-step 0.65 from a baseline median of 1200 cfu/ml, p = 0.016) indicated a significantly larger reduction in bacterial loads using the 6-step technique. • The time taken for handrub was 25{\%} (95{\%} CI: 6{\%}-14{\%}) more for the 6-step technique (p = 0.002).• The area of the hand not covered did not differ significantly between the techniques (3-step 1.02{\%}; 6-step 1.20{\%}).• The 6-step technique more frequently missed the back of hands (¿2=7.18 P=0.007 left hand; ¿2 =9.86 P=0.002 right hand).• The 3-step technique more frequently missed the back of the index (¿2=6.71 P=0.01) and the middle finger (FET: P=0.002).Conclusion: Whilst both techniques achieved good coverage of the hand surface, the 6-step technique was more effective at reducing the bacterial count than the 3-step, but was also more time consuming.",
keywords = "hand hygiene, spread of infection, health care staff, alcohol hand rub",
author = "Lesley Price and Jacqui Reilly and Susan Lang and Christopher Robertson and Francine Cheater and Angela Chow and Sandra McNamee",
year = "2014",
language = "English",

}

Price, L, Reilly, J, Lang, S, Robertson, C, Cheater, F, Chow, A & McNamee, S 2014, 'S The SHoRT Study- 6 or 3 steps to effective hand decontamination'.

S The SHoRT Study- 6 or 3 steps to effective hand decontamination. / Price, Lesley; Reilly, Jacqui; Lang, Susan; Robertson, Christopher; Cheater, Francine; Chow, Angela; McNamee, Sandra.

2014.

Research output: Contribution to conferencePaper

TY - CONF

T1 - S The SHoRT Study- 6 or 3 steps to effective hand decontamination

AU - Price, Lesley

AU - Reilly, Jacqui

AU - Lang, Susan

AU - Robertson, Christopher

AU - Cheater, Francine

AU - Chow, Angela

AU - McNamee, Sandra

PY - 2014

Y1 - 2014

N2 - Background: Little evidence exists to support the recommended hand hygiene technique for the use of handrub in clinical practice.AimTo compare the effectiveness of 6 versus 3-step handrub technique in healthcare workers. Method:• Random allocation of 48 hospital based medical and 72 nursing staff to either: o 1. Hand rubbing with alcohol based handrub covering all hand surfaces in no particular order (3-step technique)o or o 2. Hand rubbing with alcohol based handrub using the 6-step technique. • Glove juice sample of the dominant hand pre and post-handrub.• Observation of time for handrub. & the extent of hand coverage achieved.Results: • Ratios of total bacterial counts pre- and post-handrub (median 6-step 0.31 from a baseline median of 1900 cfu/ml median 3-step 0.65 from a baseline median of 1200 cfu/ml, p = 0.016) indicated a significantly larger reduction in bacterial loads using the 6-step technique. • The time taken for handrub was 25% (95% CI: 6%-14%) more for the 6-step technique (p = 0.002).• The area of the hand not covered did not differ significantly between the techniques (3-step 1.02%; 6-step 1.20%).• The 6-step technique more frequently missed the back of hands (¿2=7.18 P=0.007 left hand; ¿2 =9.86 P=0.002 right hand).• The 3-step technique more frequently missed the back of the index (¿2=6.71 P=0.01) and the middle finger (FET: P=0.002).Conclusion: Whilst both techniques achieved good coverage of the hand surface, the 6-step technique was more effective at reducing the bacterial count than the 3-step, but was also more time consuming.

AB - Background: Little evidence exists to support the recommended hand hygiene technique for the use of handrub in clinical practice.AimTo compare the effectiveness of 6 versus 3-step handrub technique in healthcare workers. Method:• Random allocation of 48 hospital based medical and 72 nursing staff to either: o 1. Hand rubbing with alcohol based handrub covering all hand surfaces in no particular order (3-step technique)o or o 2. Hand rubbing with alcohol based handrub using the 6-step technique. • Glove juice sample of the dominant hand pre and post-handrub.• Observation of time for handrub. & the extent of hand coverage achieved.Results: • Ratios of total bacterial counts pre- and post-handrub (median 6-step 0.31 from a baseline median of 1900 cfu/ml median 3-step 0.65 from a baseline median of 1200 cfu/ml, p = 0.016) indicated a significantly larger reduction in bacterial loads using the 6-step technique. • The time taken for handrub was 25% (95% CI: 6%-14%) more for the 6-step technique (p = 0.002).• The area of the hand not covered did not differ significantly between the techniques (3-step 1.02%; 6-step 1.20%).• The 6-step technique more frequently missed the back of hands (¿2=7.18 P=0.007 left hand; ¿2 =9.86 P=0.002 right hand).• The 3-step technique more frequently missed the back of the index (¿2=6.71 P=0.01) and the middle finger (FET: P=0.002).Conclusion: Whilst both techniques achieved good coverage of the hand surface, the 6-step technique was more effective at reducing the bacterial count than the 3-step, but was also more time consuming.

KW - hand hygiene

KW - spread of infection

KW - health care staff

KW - alcohol hand rub

M3 - Paper

ER -

Price L, Reilly J, Lang S, Robertson C, Cheater F, Chow A et al. S The SHoRT Study- 6 or 3 steps to effective hand decontamination. 2014.