Influence of Handprint Culture Training on Compliance of Healthcare Workers with Hand Hygiene

OBJECTIVE: We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers' (HCWs) compliance with hand hygiene (HH). SETTINGS: Medical and postoperative cardiac surgery units. DESIGN: Prospective cohort study. SUBJECT: The study included 40 HCWs. INTERVENTION: Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. MAIN RESULTS: There was a significant improvement in HH compliance following handprint culture interview (p < 0.001). The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p = 0.001; wound cultures: p = 0,003; sputum cultures: p = 0.005). CONCLUSION: The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.