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

Fingerprint

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

Keywords

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

Cite this

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title = "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",
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.",
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author = "Lesley Price and Jacqui Reilly and Susan Lang and Christopher Robertson and Francine Cheater and Angela Chow and Sandra McNamee",
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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. / Price, Lesley; Reilly, Jacqui; Lang, Susan; Robertson, Christopher; Cheater, Francine; Chow, Angela; McNamee, Sandra.

2014.

Research output: Contribution to conferencePaper

TY - CONF

T1 - 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

AU - Price, Lesley

AU - Reilly, Jacqui

AU - Lang, Susan

AU - Robertson, Christopher

AU - Cheater, Francine

AU - Chow, Angela

AU - McNamee, Sandra

N1 - pdf link to full article: http://www.his.org.uk/files/5214/1512/1837/Handbook_Abstracts.pdf 2/03/2017 TM

PY - 2014/11/16

Y1 - 2014/11/16

N2 - 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.

AB - 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.

KW - hand hygiene

KW - spread of infection

KW - health care staff

KW - alcohol hand rub

M3 - Paper

ER -