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Updated: Aug 9, 2026
09:02
A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Creating a manual for proper hand hygiene and its clinical effects
Shinya Kusachi1, Yoshinobu Sumiyama, Youichi Arima
1Third Department of Surgery, Toho University School of Medeicine, 2-17-6 Ohashi, Tokyo 153-8515, Japan.
Surgery Today
|April 25, 2006
Summary
A new hand hygiene manual effectively reduced hospital-acquired infections. Implementing clear guidelines for handwashing and glove use significantly decreased methicillin-resistant Staphylococcus aureus (MRSA) cross-infections in patients with infectious wounds.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Microbiology
Background:
- Healthcare-associated infections, particularly those caused by methicillin-resistant Staphylococcus aureus (MRSA), pose a significant challenge in clinical settings.
- Effective infection control strategies are crucial to prevent the transmission of resistant bacteria between patients and healthcare workers.
Purpose of the Study:
- To develop and evaluate a manual for the treatment of infectious wounds, emphasizing hand hygiene protocols to prevent cross-infections.
- To clarify specific guidelines for handwashing and glove use among healthcare staff treating patients with infectious wounds.
Main Methods:
- A protocol involving a hand hygiene manual was implemented for six patients with widespread MRSA-infected wounds.
- Bacterial counts on healthcare staff hands were measured before and after hand hygiene, and after patient treatment.
- The incidence of MRSA isolation in patients was monitored before and after the manual's implementation.
- MRSA isolates were typed using pulsed-field gel electrophoresis (PFGE) to assess strain relatedness.
Main Results:
- Pathogenic bacterial counts on staff hands significantly decreased from 8.2 x 10 cfu/hand before hygiene to undetectable levels after hygiene.
- Post-treatment hand hygiene reduced bacterial counts from 9.1 x 10(5) cfu/hand to 0.38 cfu/hand.
- The rate of MRSA isolation among patients decreased from 3.7% (15/402) to 1.2% (5/411) after the manual's implementation.
- PFGE analysis indicated a reduction in the diversity of MRSA strains post-implementation, with five isolates showing distinct migration patterns compared to 13 pre-implementation strains.
Conclusions:
- A structured hand hygiene manual is an effective intervention for reducing cross-infection rates in clinical settings.
- Clear protocols for handwashing and glove use are essential for controlling the spread of multidrug-resistant organisms like MRSA.
Related Concept Videos
01:18Handwashing I: Introduction and Types of Equipment
Handwashing is hand hygiene with plain or antimicrobial soap and water to physically remove dirt, organic material, and microorganisms. However, it may not kill all microorganisms. The handwashing procedure requires a hand wash basin, liquid soap, paper towels, a domestic waste bin, and disposable nail cleaner as optional equipment.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated.
01:23Hand hygiene
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
01:15Handwashing III: During the Procedure and Post-Procedure Steps
To wash hands properly, follow these steps:
01:19Handwashing II: Pre-procedure and Initial Procedure Steps
The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail paint...
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail paint...
01:26Standard Precaution
Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
01:22Healthcare Associated Infections II: Preventive Measures
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...