Effect of Hand Culture and Feedback to Healthcare Workers on Handwashing Compliance in Argentina

BACKGROUND: This study was undertaken to determine the presence of pathogenic microorganisms on the hands of healthcare workers (HCWs) and to assess the impact of this surveillance study and its feedback to HCWs on handwashing compliance. Cultures were obtained from 32 HCWs before using antimicrobial soap or alcohol-based gel. METHODS: Adherence to handwashing protocol by physicians, nursing personnel, and ancillary staff was observed in one hospital. Following an initial 1-month observation period, used to establish the institutional baseline handwashing rate during (phase 1), we cultured the hands of 32 HCWs. During November 2003, we gave the HCWs information about the microorganisms found on their hands. Surveillance of HCW handwashing was performed for another month following the intervention (phase 2). RESULTS: Between October 2003 and December 2003, 1191 potential handwashing opportunities were observed. The baseline rate of HCW handwashing compliance before the intervention was 47.2% (301/637). After the intervention, HCW handwashing before patient contact increased to 78.5% (435/554) (RR 1.66; 95% CI 1.43–1.92, p < 0.0001). CONCLUSIONS: In this study, culturing the hands of HCWs significantly improved compliance with a handwashing protocol.