Hand profiling: A novel tool used to demonstrate hand hygiene technique

Hand hygiene is the most important measure to prevent hospital-acquired infection, yet hand hygiene compliance rates are poor in intensive care units (ICUs). Handprofiling using fingertip imprints was used to demonstrate the effectiveness of alcohol hand rub (AHR) on reducing bacterial carriage and to assess AHR application as an additional educational tool in the ICU setting. At each hand hygiene opportunity, fingertip imprints, from both hands of the Director of the ICU, were plated and organisms cultured during a patient examination. Micro-organisms were counted and speciated. Hands were examined for general condition and details documented. After presenting the evidence of the value of appropriate hand hygiene to the unit head, the plating activity (hand profiling) was made available to any ICU staff. Nearly twice the number of micro-organisms were plated from the dominant hand fingertips of the Director of the ICU compared with his non-dominant hand. Following the application of AHR, the number of organisms reduced but the right thumb consistently grew micro-organisms. An examination of his hand hygiene technique demonstrated the need to focus on his right thumb when applying AHR. Sixty-five ICU and visiting clinical staff participated in assessing hand hygiene technique after AHR application. Twenty-four staff were recommended for follow-up review of their hand hygiene technique. Through hand profiling, an improvement in application of AHR was demonstrated after the technique was corrected. Hand profiling is a useful educational tool and could be made available to clinical staff to maximise the efficacy of AHR application.