Hand hygiene in medical students: performance, education and knowledge

Despite several guidelines on hand hygiene (HH), compliance especially in physicians is reported to be low which has huge implications for healthcare-associated infections. To evaluate performance of HH, influence of teaching and influence of monitoring the results in medical students, we conducted an observational study.

Performance of hand disinfection was evaluated in first (N=28), third (N=193) and fifth (N=45) year medical students using fluorescent hand disinfectant. The influence of teaching and information about result control was assessed. The students perception of the impact of HH was also evaluated by a questionnaire.

Presence of disinfectant gaps was observed significantly more often in first year medical students compared to third year ones (82% vs, 60%; p=0.02). In additional, > 3 gaps were seen significantly more often in first year medical students compared to fifth year students (36% vs. 9%; p=0.007). Both information about teaching and monitoring the results improved outcome significantly. For example, gaps were present in 92% without information and without teaching, in 70% (RR: 1.3 (1.0-1.6); p=0.003) with information about result control only, and in only 18% (5.1 (3.0-8.5); p=0.0001) after teaching. Notably, the medical students ascribed HH to be of a great importance regardless of their level of education.

Performance of HH could be improved by practical training as evidenced by best HH performance being documented immediately after teaching and a training effect during the course of medical studies was also observed. Thus, we suggest implementing regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care. regular education and practical training on HH from early on in the medical studies curricula to improve overall quality of patient care.