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Five-step handwashing technique improves children’s health
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A five-step handwashing technique improved the health of children with mild intellectual disability, according to recent data. The technique simplified the WHO recommended seven-step routine.
“Our study showed that both the intervention and control schools had improved their handwashing technique,” Regina L.T. Lee, PhD, of Hong Kong Polytechnic University, and colleagues wrote. “Students in this study showed better performance in simplified handwashing techniques and experienced lower absenteeism than those using usual practice in special education school settings.”
Regina L.T. Lee
The five-step technique washes the thumbs, the finger tips, the backs of hands and fingers, and between fingers. The technique omits the WHO-recommended wrist-rubbing step because rinsing the wrist may wet the sleeves, allowing bacteria to grow, and combines two other steps into one.
In a quasi-experimental study conducted at two special education schools in Hong Kong, children in the intervention group were encouraged to use the five-step technique with a song, poster, checklist, video and reward system. In the control group, the researchers promoted the WHO seven-step technique with education used by the Centre for Health Protection in Hong Kong. The children were aged 6 to 16 years; 74.2% were boys.
The researchers used fluorescent stain to cover the hands of children and observed the change in the amount of fluorescence under ultraviolet light to evaluate the technique. They used a 4-point scale (0-3) to measure how much fluorescent stain was removed and to rate the effectiveness of the handwashing technique. A rating of 0 required 75% to 100% of the hands to be covered in fluorescent stain, 1 required 50% to 75%, 2 required 25% to 50%, and 3 required 0% to 25%. Four weeks after initial evaluation, the researchers randomly selected 78 children from the intervention group and determined whether they could repeat the technique effectively. The researchers also assessed whether the technique reduced sickness-related absences.
The researchers saw greater improvements in handwashing in the intervention group (+1.03; P < .001) compared with controls (+0.34; P = .001). They found no decrease in handwashing rating among children at 4 weeks. The researchers also saw less absenteeism in the intervention group (P = .04).
“It is very important in the public health agenda to standardize a handwashing program for school teachers and school nurses to teach vulnerable high-risk groups about handwashing procedures and ultimately to prevent the spread of germs in the school community,” Lee and colleagues wrote. “It is hoped that the study results will draw recommendations to standardize implementation of this simplified five-step handwashing technique.” – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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