Document Type : Original Article

Authors

Abstract

BACKGROUND: Washing of hands and maintenance of appropriate hand hygiene plays a significant
role in preventing the spread of many communicable diseases. However, literature demonstrating
the efficacy of the World Health Organization (WHO) recommended handwashing procedure among
schoolchildren in India is scanty.
AIM: The aim of this study was to assess hand hygiene efficacy through graphical assessment
technique utilizing ultraviolet (UV)‑sensitive fluorescent lotion before and after handwashing
demonstration among students aged 12–18 years.
MATERIALS AND METHODS: This was an interventional study carried out over a period of 5 days
among 21 schoolchildren aged 12–18 years in their respective school premises. Participants were
requested to rub their hands with an UV‑sensitive fluorescent lotion and then wash them. Hands
were air‑dried and examined under UV rays for blue light emission in a dark room. Emission of blue
light highlighted parts of hand where lotion is still present and area not washed properly. Such areas
were painted with nontoxic skin‑friendly paints. Painted hands were imprinted over graph papers.
Hand hygiene demonstration was provided to the participants as per the WHO guidelines by qualified
public health dentists using audiovisual aids. Postintervention, the procedure followed at baseline
was adopted to obtain imprints of uncovered (not covered during hand hygiene process) parts of
hands. The mean percentage of uncovered parts of hand was assessed and compared between
baseline and postintervention.
RESULTS: The overall mean percentage score of uncovered hand area significantly reduced from
73.90 ± 19.81 mm2
 at baseline to 20.05 ± 17.0 mm2
 after demonstration of proper hand hygiene
guidelines (P < 0.001).
CONCLUSION: Hand hygiene demonstration by qualified public health dentists using audio‑visual
aids has significantly contributed to improving their hand hygiene practice.

Keywords

  1. Omuemu VO, Ogboghodo EO, OpeneRA, Oriarewo P, OnibereO.
    Hand hygiene practices among doctors in a tertiary health facility
    in southern Nigeria. J Med Trop 2013;15:96‑101.
    2. Center for Disease Control and Prevention 24/7: Saving Lives,
    Protecting People. Global Hand washing Day. Available from:
    https://www.cdc.gov/features/globalhandwashing/index.
    html. [Last accessed on 2020 Apr 16].
    3. United Nations Children‘s Fund (UNICEF). UNICEF on Global
    Hand Washing Day: A Simple Solution with far Reaching
    Benefits‑the Power is in our Hands; 2013. Available from: https://
    www.unicef.org/media/media_70665.html. [Last accessed on
    2020 Apr 16].
    4. Kumar JK, Patthi B, Singla A, Gupta R, Prasad M, Pandita V,
    et al. Graphical assessment technique (GAT)‑An objective,
    comprehensive and comparative hand hygiene quantification
    tool. J Clin Diagn Res 2016;10:ZC118‑22.
    5. World Health Organization. Save Lives Clean Your Hands. Hand
    Hygiene in Outpatient and Home‑based Care and Long‑term
    Care Facilities; c2012. Available from: https://www.who.int/
    gpsc/5may/hh_guide.pdf. [Last accessed on 2020 Apr 16].
    6. World Health Organization. WHO Guidelines on Hand Hygiene
    in Health Care. First Global Patient Safety Challenge. Clean Care
    is Safer Care; c2009. Available from: https://apps.who.int/iris/
    bitstream/handle/10665/44102/9789241597906_eng.pdf; jsessio
    nid=05558F87A832B92C35F8DE6A214B723F?sequence=1. [Last
    accessed on 2020 Apr 16].
    7. World Health Organization. Clean Care is Safer Care ‑ The
    Evidence for Clean Hands. Testing the WHO Guidelines on Hand
    Hygiene in Health care in Eight Pilot Sites Worldwide; c2017.
    Available from: http://www.who.int/gpsc/country_work/
    pilot_sites/introduction/en/. [Last accessed on 2020 Apr 16].
    8. World Health Organization. Save Lives: Clean Your Hands
    WHO’s Global Annual Campaign Advocacy Toolkit. Available
    from: http://www.who.int/gpsc/5may_advocacy‑toolkit.
    pdf?ua=1. [Last accessed on 2020 Apr 16].
    9. World Health Organization. Clean Care is Safer Care. Save
    Lives: Clean Your Hands ‑ WHO’s Global Annual Call to Action
    for Health Workers. Registration Update ‑ Countries or Areas.
    Available from: http://www.who.int/gpsc/5may/registration_
    update/en/. [Last accessed on 2020 Apr 16].
    10. de Amorim‑Finzi MB, Cury MV, Costa CR, Dos Santos AC,
    de Melo GB. Rate of compliance with hand hygiene by dental
    healthcare personnel (DHCP) within a dentistry healthcare first
    aid facility. Eur J Dent 2010;4:233‑7.
    11. Thivichon‑Prince B, Barsotti O, GirardR, MorrierJJ. Hand hygiene
    practices in a dental teaching center: Measures and improve. Eur
    J Dent 2014;8:481‑6.
  2. 12. Larson E, Lusk E. Evaluating hand washing technique. J Adv
    Nurs 2006;53:46‑53.
    13. Sharma S, Sharma S, Puri S, Whig J. Hand hygiene compliance
    in the intensive care units of a tertiary care hospital. Indian J
    Community Med 2011;36:217‑21.
    14. Lehotsky Á, Szilágyi L, Demeter‑Iclănzan A, Haidegger T,
    WébER G. Education of hand rubbing technique to prospective
    medical staff, employing UV‑based digital imaging technology.
    Acta Microbiol Immunol Hung 2016;63:217‑28.
    15. Vanyolos E, Peto K, Viszlai A, Miko I, Furka I, Nemeth N, et al.
    Usage of ultraviolet test method for monitoring the efficacy of
    surgical hand rub technique among medical students. J Surg Educ
    2015;72:530‑5.
    16. Lehotsky Á, Szilágyi L, Bánsághi S, Szerémy P, Wéber G,
    Haidegger T. Towards objective hand hygiene technique
    assessment – Validation of the UV dye based hand rubbing quality
    assessment procedure. J Hosp Infect 2017;97: 26‑9.
    17. Kumar JK, Patthi B, Singla A, Gupta R, Prasad M, Ali I. The hand
    hygiene objective graphical assessment index: An index to assess
    macroscopic hand hygiene efficiency. JIndian Assoc Public Health
    Dent 2017;15:116‑21.
    18. Widmer AF, Conzelmann M, Tomic M, Frei R, Stranden AM.
    Introducing alcohol‑based hand rub for hand hygiene: The
    critical need for training. Infect Control Hosp Epidemiol
    2007;28:50‑4.
    19. Lehotsky Á, Szilágyi L, Ferenci T, Kovács L, Pethes R, Wéber G,
    et al. Quantitative impact of direct, personal feedback on hand
    hygiene technique. J Hosp Infect 2015;91:81‑4.