title: Adherence to surgical hand rubbing directives in a hospital district of Southwest Finland.
abstract: BACKGROUND
  The primary objective was to measure the compliance with alcohol-based surgical hand rubbing (SHR) among operation room personnel. The secondary objective was to evaluate the effect of feedback sessions on compliance.
  
  
  METHODS
  This was a prospective observational before-after intervention study. Between October 2010 and June 2012 the hygiene nurses observed SHR among operation room personnel in the hospital district of Southwest Finland. After feedback sessions a second observation round was conducted in the main operation room of Turku University Hospital. The first observation round comprised 477 observations: 259 (54%) were doctors, 190 (40%) nurses and 28 (5%) other personnel. In the second observation round a total of 210 observations were made.
  
  
  RESULTS
  During the first round in 42% of observations the 3 min SHR time recommended by WHO was used. Median times for SHR were 1 min 50 s (range 0 min to 5 min 44 s) for doctors and 3 min 25 s (range 1 min 1 s to 8 min 15 s) for nurses, respectively (p < 0.0001). In 40% of observations hands were not properly dried after a wash before applying SHR and in 45% hands were not allowed to dry properly after SHR before donning surgical gloves. After feedback, time for SHR did not significantly improve but technique did.
  
  
  CONCLUSIONS
  SHR was performed incorrectly in most observations even after feedback. The results stress the importance of more effective education, helping techniques and positive role models for operation room personnel to promote SHR.
authors.affiliation: a University of Turku , and.
authors.forename: Erkki
authors.initials: E
authors.lastname: Laurikainen
authors.affiliation: b Department of Hospital Hygiene and Infection Control , Turku University Central Hospital , Turku , Finland.
authors.forename: Esa
authors.initials: E
authors.lastname: Rintala
authors.affiliation: b Department of Hospital Hygiene and Infection Control , Turku University Central Hospital , Turku , Finland.
authors.forename: Anne-Mari
authors.initials: AM
authors.lastname: Kaarto
authors.affiliation: b Department of Hospital Hygiene and Infection Control , Turku University Central Hospital , Turku , Finland.
authors.forename: Marianne
authors.initials: M
authors.lastname: Routamaa
mesh_terms: D004202:Disinfectants / Q000008:administration & dosage*; D005260:Female; D005387:Finland; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods*; D006282:Health Personnel; D006785:Hospitals, University; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*
chemical_list: D004202:Disinfectants
keywords: Surgical hand disinfection; compliance; surgical hand rubbing