UNDERSTANDING OF HAND RUB PRODUCT EFFECTIVENESS: INFLUENCE OF DIFFERENT CULTURE SAMPLING TECHNIQUES

Background: Hand hygiene is the most effective way to reduce the spread of pathogens and the incidence of healthcare-associated infections (HAIs) in health care facilities. The effectiveness of the hand rub in eliminating microorganisms from the surface of hands was assessed through hand culture. Two hand culture sampling techniques that are often used to assess the effectiveness of handwashing are hand-gloves and swab technique. Purpose: This study aims to compare the culture sampling technique in assessing the effectiveness of handwashing using alcohol-based hand rub products. Methods: An experimental study conducted at Dr. Soetomo Hospital, Surabaya, with 20 resident and nurse respondents. Handwashing was using an alcohol-based hand rub according to the WHO recommended method. Hand culture samples were taken, before and after handwashing, using hand-gloves and swab techniques. The data were analysed using Wilcoxon Rank test, ANOVA test and Linear regression. Results: This study showed a significant difference before and after handwashing using hand rub in eliminating microorganisms on the hands (Sig = 0.000). However, the effectiveness of using three alcohol-based hand rub products (chlorhexidine gluconate, n-propanol, and hydrogen peroxide) in eliminating microorganisms is the same. This study also shows no significant difference between the application of three hand rub products in all hand culture sampling techniques used (Sig = 0.126). There are differences in the use of culture sampling techniques to assess hand culture results (Sig = 0.000). Conclusion: The use of alcohol-based hand rub products with the combination of chlorhexidine gluconate, n-propanol, and hydrogen peroxide has the same effectiveness in eliminating microbes on the hands surface. The hand-gloves technique better describes the elimination of microorganisms after handwashing. Although it cannot replace the hand-gloves technique, the swab technique may be used as an alternative technique in peripheral health care facilities.