The World Health Organization (WHO) and the Centers for Disease Control (CDC) recommend different approaches to handwashing. A new study by WHO recommends a six-step approach to wash hands, compared to CDC’s three step approach. The study found that the six-step hand hygiene technique did a better job at killing a larger number of germs than the CDC hand cleaning method.

The study by WHO (journals.cambridge.org) was published last week in the journal “Infection Control & Hospital Epidemiology,” focuses on the use of hand sanitizer, which is often used in the hospital setting to prevent the transmission of infections. The lead researcher of the study, Jacqui Reilly, professor of infection prevention at Glasgow Caledonian University in Scotland, says “It’s quite a complex maneuver I describe it as a ballet dance.”

The WHO method includes rubbing palms together, interlacing fingers, and focusing on the backs of the fingers.  The CDC said in an Wall Street Journal article, it’s approach is similar but less detailed. “We’re on the same page here. We just do not get into that kind of detail in our guideline,” said Clifford McDonald, a CDC epidemiologist.

The WHO study conducted a randomized controlled trial of 120 doctors and nurses. The researchers found that those who used the WHO method, rather than the CDC handwashing instructions, had less bacteria on their hands. The researchers were surprised by the results, since their initial premise was to ask whether it is necessary to “make hand hygiene so complicated,” said Dr. Reilly. “The six-step method in our study was demonstrated to be superior,” she said.

Only 65 percent of respondents were able to use the six-step hand washing method properly, versus 100 percent compliance by those using the CDC three step method.  Despite this fact, the six-step method proved to be more efficient in killing bacteria. The WHO study showed that it took 42.5 seconds to complete the six-step method, and 35 seconds to follow the more general CDC instructions. The study findings are important because hand-cleaning in the hospital setting is vital to reducing the potential to spread infections, and is a major public health issue.

Source: “A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute Hospital Care in the United Kingdom,” journal “Infection & Hospital Epidemiology”

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