Chugh Yashasvi, Baligathe Shrikala
Intern, Kasturba Medical College , Mangalore, India .
J Clin Diagn Res. 2013 Mar;7(3):434-6. doi: 10.7860/JCDR/2013/4779.2792. Epub 2013 Mar 1.
The hands harbour a kaleidoscope of bacteria, thus making hand washing an essential attribute in preventing the transmission of nosocomial pathogens. Medical students, as a part of their curriculum, are taught about handwashing. However, their adherence to it is doubtful. This study was carried out to ascertain the impact of educating medical students about the correct technique of handwashing and its role in reducing the bacterial contamination of their hands.
The hands of 50 medical students who attended the clinical postings were screened for bacterial colonisation. Following their screening, 30 students who had the highest colonization of bacteria were followed up for a second round of sampling. They were further allotted into two arbitrary groups: the control group and the test group. The procedure for an adequate handwash was taught to the test group, whereas the control group had been taught it as a part of their clinical curriculum during their postings. Each student's hands were sampled, both preceding and following a handwash.
Following the handwashing, the students of the test group had a significantly (p=0.011) lower mean bacterial colonization on their hands, in contrast to the control group. Moreover, 86.7% of the students from the control group harboured Staphylococcus aureus even after handwashing, whereas only 40% of the test group students had it. The preliminary screening concluded that: (i) Females harboured a significantly greater (p=0.038) bacterial colonization on their hands than males.(ii) The students who wore rings showed a higher contamination (p=0.05).
This study revealed that the students of the test group were at an advantage, as they had been given immediate prior instructions, whereas the control group had been taught the same technique at their clinical postings and were not instructed preceding the handwash and the sample collection. It can be concluded that a prior instruction in the form of teaching or visual aids such as posters etc., regarding the method of handwashing, is essential for an effective handwash, regardless of the past teaching. The instruction that is imparted to the students as a part of their curriculum needs reinforcement.
手上存在各种各样的细菌，因此洗手是预防医院病原体传播的一项基本措施。医学生在其课程学习中会接受关于洗手的教育。然而，他们对洗手的依从性令人怀疑。本研究旨在确定对医学生进行正确洗手技术教育及其在减少手部细菌污染方面的作用。
对50名参加临床实习的医学生的手部进行细菌定植筛查。筛查后，对细菌定植量最高的30名学生进行第二轮采样随访。他们被随机分为两组：对照组和试验组。试验组接受了正确洗手程序的培训，而对照组在实习期间已将其作为临床课程的一部分进行了学习。在洗手前后分别对每个学生的手部进行采样。
洗手后，试验组学生手上的平均细菌定植量显著低于对照组（p = 0.011）。此外，对照组86.7%的学生即使洗手后手上仍携带金黄色葡萄球菌，而试验组只有40%的学生携带。初步筛查得出：（i）女性手上的细菌定植量显著高于男性（p = 0.038）。（ii）戴戒指的学生污染程度更高（p = 0.05）。
本研究表明，试验组学生具有优势，因为他们在洗手前得到了即时指导，而对照组在临床实习期间学习了相同的技术，但在洗手和采样前未得到指导。可以得出结论，无论过去是否接受过相关教育，以教学或海报等视觉辅助形式对手洗方法进行预先指导对于有效洗手至关重要。作为课程一部分传授给学生的指导需要加强。
