Evaluating the Effectiveness of the WHO 6-Step Hand Hygiene Technique: Impact of Step Omission and Duration on...

The World Health Organization has proposed practical recommendations for hand hygiene, which include a six-step technique for hand washing and hand rubbing with antiseptic agents. Hand hygiene has become one of the five key elements of the patient safety program. However, adherence to all six steps of hygienic handrub among medical staff is quite low. In our study, we evaluated the effectiveness of reducing microbial load on the skin of hands depending on the number of steps performed and the duration of handrub.

The preparation of the contamination fluid and the contamination of the volunteers' hand skin were carried out according to the European standard EN 1500. Subsequently handrub was performed using an alcohol-based antiseptic with various modifications of the six-step technique, either excluding certain elements or reducing the time spent on each step. After the handrub, swabs were performed, and the number of viable microorganisms in the obtained samples was determined.

Adherence to all stages of the WHO-recommended 6-step hand hygiene technique provided effective decontamination of hand skin. Using all six steps for 30 seconds resulted in a log reduction of microorganisms up to 2.82 (mean value of colony-forming unit (CFU) = 2.024×10³ (95% confidence interval (CI) ±0.545×10³). Reducing the duration of antiseptic use from 30 to 15 seconds did not decrease the effectiveness of the antiseptic action.

Based on the conducted experimental studies, it can be concluded that following the WHO-recommended algorithm for hand hygiene significantly reduces the contamination of the skin surface with test cultures.