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http://hdl.handle.net/10397/106786
Title: | Factors associated with hand washing effectiveness : an institution-based observational study | Authors: | Shi, C O’Donoghue, M Yang, L Tsang, H Chen, J Zou, J Qin, J Mak, YW Pittet, D Xie, YJ Lai, T Li, C Cao, J |
Issue Date: | 2023 | Source: | Antimicrobial resistance and infection control, 2023, v. 12, 85 | Abstract: | Background: Few studies have investigated how the effectiveness of hand washing in removing hand contaminants is influenced by the performance and duration of each step involved. We conducted an observational study by recruiting participants from a university campus, with the aim to comprehensively evaluate how performance, duration and demographic factors influence hand washing effectiveness. Methods: A total of 744 videos were collected from 664 participants in July-October 2022 and independently evaluated by two infection control experts through labelling videos for correct and incorrect performance of each step. The individual hand washing effectiveness was determined by quantifying the percentage of residual fluorescent gel on the dorsum and palm areas of each participant’s hands. A logistic regression analysis was conducted to identify factors that were significantly associated with better hand washing effectiveness. An exposure-response relationship was constructed to identify optimal durations for each step. Approximately 2300 hand images were processed using advanced normalization algorithms and overlaid to visualize the areas with more fluorescence residuals after hand washing. Results: Step 3 (rub between fingers) was the most frequently omitted step and step 4 (rub the dorsum of fingers) was the most frequently incorrectly performed step. After adjustment for covariates, sex, performance of step 4 and step 7 (rub wrists), rubbing hands during rinsing, and rinsing time were significantly associated with hand washing effectiveness. The optimal overall hand washing time was 31 s from step 1 to step 7, and 28 s from step 1 to step 6, with each step ideally lasting 4–5 s, except step 3. The palms of both hands had less fluorescence residuals than the dorsums. The areas where residuals most likely appeared were wrists, followed by finger tips, finger webs and thumbs. Conclusions: Performance and duration of some hand washing steps, sex and rinsing time were associated with hand washing effectiveness. The optimal duration might be applied to all seven steps to achieve the best decontamination results. Further studies are needed to refine hand hygiene standards and enhance compliance. |
Keywords: | Hand hygiene Hand washing Infection prevention and control Standards |
Publisher: | BioMed Central Ltd. | Journal: | Antimicrobial resistance and infection control | EISSN: | 2047-2994 | DOI: | 10.1186/s13756-023-01293-1 | Rights: | © The Author(s) 2023. Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. The following publication Shi, C., O’Donoghue, M., Yang, L. et al. Factors associated with hand washing effectiveness: an institution-based observational study. Antimicrob Resist Infect Control 12, 85 (2023) is available at https://doi.org/10.1186/s13756-023-01293-1. |
Appears in Collections: | Journal/Magazine Article |
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s13756-023-01293-1.pdf | 1.45 MB | Adobe PDF | View/Open |
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