Semmelweis's Forgotten Gift: Has Handwashing Lost Its Importance?

BACKGROUND AND OBJECTIVES

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.

METHODS

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.

RESULTS

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).

INTERPRETATION AND CONCLUSION

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.