Improving hand-washing performance – a crossover study of hand-washing in the orthopaedic department

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Effective hand-washing is essential for reducing the spread of infection in hospitals. We aimed to evaluate performance of hospital personnel and to determine if this could be improved by education.


A total of 55 personnel working in the orthopaedic department were asked to clean their hands using an alcohol gel containing a clear fluorescent substance. They were unaware of the assessment method. Performance was assessed by examining their hands under UV light to identify areas that had been neglected. Subjects could visualise which areas they had missed and were then educated regarding hand-washing technique and retested after 7 days.


Of the 55 subjects, 53 completed the study. Individual performance varied widely. Following a simple educational intervention, 49 out of 53 subjects improved from an average of 7.8% to 2.3% area missed (P < 0.001).


We suggest that hand-washing effectiveness needs to be improved and that a simple educational intervention can be effective.

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