How to wash your hands

Advising healthcare workers to spend less time washing their hands may encourage them to do it more often, a new study suggests.

And that might ultimately help in further reducing the spread of infectious diseases in hospitals and similar settings.

The World Health Organisation recommends a 30-second, six-stage procedure with alcohol rub, but that can be pretty onerous for busy staff who have to do it many times each day.

As researchers from University Hospital Basel in Switzerland acknowledge, adherence to the whole routine is low.

They believe a 15-second, three-stage procedure is no less effective, on the strength of two studies

In the first, in 2017, Sarah Tschudin-Sutter and colleagues showed that three steps are as effective as six.

In more recent work, the same team randomly assigned 20 healthy volunteers aged 18 to 51 years to rub their hands by following four different techniques: six-step or three-step for either 30 or 15 seconds. 

The “primary endpoint” – as explained in the group’s poster presentation  to the recent European Congress of Clinical Microbiology & Infectious Diseases in Amsterdam – was “the bacterial counts on the dominant hand as determined by the mean logarithmic reduction in bacterial counts after performance of hand hygiene”.

In that context, 15 seconds was found to be “non-inferior” to 30 seconds using either technique – and might be superior in terms of helping healthcare workers comply with 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,” says Tschudin-Sutter.

The researchers acknowledge that the new study was carried out in an experimental rather than a clinical setting and that, as they measured the reduction of bacterial counts, conclusions cannot be made about the impact of different hand hygiene techniques on transmission of pathogens.

It’s also not clear whether the suggested new regime would work on children.

The WHO has a separate recommended procedure for washing hands with water. It “takes about as long as singing ‘Happy Birthday’ twice”.