Related Experiment Video
Updated: Jun 10, 2025

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Clinical Effectiveness of a 3-Step Versus a 6-Step Hand Hygiene Technique: A Randomized Controlled Cross-over Study
Nuo Chen1,2, Yan Li2, Wenbin He3
1School of Public Health, Hubei University of Medicine, Shiyan, Hubei, China.
Background:
The aim of this study is to assess the clinical effectiveness of the 3-step hand hygiene (HH) technique (3-HT) compared with the 6-step HH technique (6-HT; World Health Organization 6-step technique) using an alcohol-based hand rub.
Methods:
A randomized controlled crossover trial was conducted from November to December 2023 in 10 wards of a tertiary A-level hospital according to CONSORT guidelines. The 240 healthcare workers (HCWs) were randomly divided into the 3-HT intervention group or the 6-HT control group. The trial was conducted in 2 stages, and the effectiveness of each indicator in the 2 groups was compared after a washout period of 2 weeks.
Results:
Compared with the 6-HT, the 3-HT has demonstrated significant superiority in all indicators of HH compliance as well as the accuracy rate of HH practices. The total HH median times for the 3-HT and 6-HT were 16.00 (interquartile range, 15.00-20.00) and 32.50 (30.00-40.00) seconds, respectively (P < .05). The reduction factors for bacterial colony-forming unit counts did not differ and the colony-forming unit counts were not significantly different. Bacillus, Staphylococcus, and Micrococcus were detected before and after the use of hand rubs. HCWs preferred the 3-HT over the 6-HT. There were no significant difference in healthcare-associated infections rate between the 2 techniques.
Conclusions:
The 3-HT was significantly superior to the 6-HT in terms of the HH eligibility rate, compliance, and HH time. The safety and feasibility of the 3-HT were verified by assessing microorganism count.
Related Concept Videos
Hand hygiene
Hand washing...
Handwashing III: During the Procedure and Post-Procedure Steps
Handwashing II: Pre-procedure and Initial Procedure Steps
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...
Antimicrobial Effectiveness
PPE Use in Healthcare Settings II: Doffing

