title: Improving hand-washing performance - a crossover study of hand-washing in the orthopaedic department.
abstract: BACKGROUND
  Effective hand-washing is essential for reducing the spread of infection in hospitals. We aimed to evaluate hand-washing performance of hospital personnel and to determine if this could be improved by education.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  We suggest that hand-washing effectiveness needs to be improved and that a simple educational intervention can be effective.
authors.affiliation: Department of Orthopaedics, The Western Infirmary, Glasgow, UK. djmmacd@hotmail.com
authors.forename: Duncan J M
authors.initials: DJ
authors.lastname: Macdonald
authors.forename: Elisabeth C A
authors.initials: EC
authors.lastname: McKillop
authors.forename: Sylvia
authors.initials: S
authors.lastname: Trotter
authors.forename: Alastair
authors.initials: A
authors.lastname: Gray
mesh_terms: D000328:Adult; D003428:Cross Infection / Q000517:prevention & control*; D018592:Cross-Over Studies; D005260:Female; D006235:Hand Disinfection / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000592:standards*; D008297:Male; D009985:Orthopedics; D010564:Personnel, Hospital / Q000193:education*