Simplified handwashing steps help reduce sickness-related absenteeism for kids

The study was conducted in two special education schools in Hong Kong. Researchers from The Hong Kong Polytechnic University developed a 12-week handwashing intervention which reduced the World Health Organization's seven-step handwashing technique to five steps by combining two of the steps (palm-to-palm and palm-to-palm with fingers interlaced) and omitting one (wrist-rubbing).

The researchers compared hand hygiene improvement measurements between the intervention (five-step method) and control (seven-step method) groups after the implementation of the simplified program using fluorescent stain test photos to analyze the results. The pre- to post-test difference in the intervention school (+1.03, P <.001) was 212 percent greater than the difference in the control school where the seven-step guideline was followed (+0.34, P = .001).

Sickness-related absenteeism was also reduced by 40 percent more in the intervention school (0.0167) compared with the control school (0.028).

"It is very important in the public health agenda to standardize a handwashing program for school teachers and school nurses to teach vulnerable high-risk groups about handwashing procedures and ultimately to prevent the spread of germs in the school community," the researchers concluded.

The intervention consisted of the following: (1) the simplified 5-step handwashing technique, including demonstrations and return demonstrations; (2) a handwashing song; (3) a video for behavior modeling; (4) a poster giving visual cues for the five steps of the handwashing procedure; (5) a reward card system for behavioral reinforcement; and (6) a validated handwashing checklist for concordance observation.