Hand Hygiene Accuracy of Students and Staff at a Dutch Dental School

Oral health care professionals continuously come into contact with bodily fluids containing many pathogens. Hand hygiene should be used to prevent cross transmission. We aimed to examine the accuracy of application of alcohol-based hand rub (ABHR) according to the WHO hand hygiene steps at a dental school.

Students and staff filled out a short questionnaire to obtain demographic data and answered questions on their perceived efficacy and knowledge of their hand hygiene. Participants rubbed their hands as they usually do when working in the clinic using an ABHR supplemented with a fluorescent marker, after which the dorsal and palmar sides of both hands were photographed. Photographs were scored according to the steps of the WHO guideline. Parts of the hands were scored as completely or insufficiently covered with ABHR.

The average hand hygiene accuracy of Dutch dental students and staff was 59%. Only 2.8% of them had excellent accuracy of hand hygiene. The most inefficiently performed steps were rubbing the thumb and rubbing the backs of the fingers to opposing palms. No differences could be observed according to student training year or being student or staff.

Overall, hand hygiene accuracy at a Dutch dental school was comparable to that observed in other health care sectors. Only a few participants demonstrated excellent technique and performance was not associated with educational level. These findings highlight the need for greater emphasis on hand hygiene in dental curricula as well as complementary strategies for improving hand hygiene.