The SHoRT Study- 6 or 3 steps to effective hand decontamination: a randomised controlled trial of the use of alcohol hand rub in healthcare workers

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:  1. Hand rubbing with alcohol based handrub covering all hand surfaces in no particular order (3-step technique) or 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 - 16 Nov 2014

Keywords

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

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