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Updated: Jan 17, 2026

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Handwashing by healthcare staff using a modified Ayliffe technique to prevent infection transmission
Anirban Mandal1, Karishma Nursiah2, Mehvish Jamal2
1Plastic Surgeon, The Mersey Regional Burns and Plastic Surgery Unit, Mersey and West Lancashire Teaching Hospitals NHS Trust, Knowsley.
Background:
Hand hygiene is one of the most significant components of standard infection control precautions.
Aim:
This study aimed to assess local hand hygiene technique and the effectiveness of an instructional video plus adding a seventh step to the Ayliffe technique.
Method:
Adherence of practitioners to the six-step Ayliffe technique and its effectiveness were assessed using a lotion that shows areas not cleansed adequately under ultraviolet light. This was followed by a short instructional video plus an added step to improve cleansing of the dorsal hand. Technique was re-evaluated immediately and 3-4 weeks later.
Findings:
43% of participants correctly performed all six steps of the Ayliffe technique during the initial assessment; this rose to 97% after watching the video. A majority (59%) of participants initially missed the dorsal hands, which improved to 13% at the third assessment.
Conclusions:
An instructional video is an effective tool for improving hand hygiene technique. Adding the seventh step to the Ayliffe technique improves coverage of the dorsal hand so will increase the effectiveness of hand hygiene protocols.
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