Six-Step Hand-Washing Process Proves Superior in Beating Bacteria



Hand hygiene is essential to any dental procedure. While the Centers for Disease Control and Prevention suggest a 3-step hand-washing process, Glasgow Caledonian University reports that the 6-step process from the World Health Organization does a better job in reducing bacteria.

“This study provides the first evidence of applied research from a randomized controlled trial (RCT) that the 6-step technique is superior to the 3-step technique in reducing the residual bacterial load after alcohol-based hand-run hand-hygiene,” said Professor Jacqui Reilly, leader of the research team.

“The reduction was not related to coverage, type of organism, or staff group,” Reilly said. “Further well-designed, applied RCTs are needed to evidence much of what is ritual in infection prevention and control practice.”

During the RCT, researchers observed 42 physicians and 78 nurses completing hand-washing using an alcohol-based hand rub after delivering patient care in an urban, acute-care teaching hospital in Glasgow.

The 6-step method reduced the median bacterial count from 3.28 to 2.58, while the 3-step method reduced it from 3.08 to 2.88. However, the 6-step method required 42.5 seconds, while the 3-step method required 35 seconds. Also, compliance with the 6-step method was lacking.

“Only 65% of providers completed the entire hand hygiene process despite having instructions on the technique in front of them and having their technique observed,” said Reilly. “This warrants further investigation for this particular technique and how compliance rates can be improved.”

Using an alcohol-based hand rub, the 6 steps include:

  • Rubbing the palms against each other;
  • Rubbing the back of each hand against the palms;
  • Rubbing the palms together with the fingers interlaced;
  • Rubbing the palms together with the fingers interlocked;
  • Rubbing the fingers around each of the thumbs;
  • Rubbing each palm with the tips of the fingers.

The study, “A Pragmatic Randomized Controlled Trial of 6-Step Vs. 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom,” was published by Infection Control & Hospital Epidemiology.

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