Qualitative observational assessment of the 6-steps of hand rubbing technique practiced among medical students, interns and residents at a tertiary center.

Miss Raghad Alotaibi1, Miss Farah Alotaibi2, Mr. Mazin Barry1, Miss Lama Alotaibi1

1King Khalid University Hospital, Riyadh, Saudi Arabia,
2Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia


Health care associated infection (HCAI) bears a huge burden around the world. Hand hygiene (HH) has been proven to be a cornerstone of its prevention. Several promotional campaigns helped in rising Healthcare workers(HCWs) compliance to HH but a negligible sum of evidence examined the technique practiced by HCWs, a segment that might have been overlooked as a cause of HCAI transmission.


Our aim is to evaluate the quality of Hand rubbing (HR) technique among medical students, interns, and residents based on the 6-steps of HR recommended by the World Health Organization.


We conducted a cross-sectional analysis at King Khalid University Hospital(KKUH) in Saudi Arabia. Convenient sampling was used to include students, interns and residents. Data collectors requested participants to voluntarily perform the HR using an alcohol-based formulation and recorded their score from zero to twelve. Time consumed and jewelry removal were also recorded.


Out of 377 total participants, only 2.65%(n=10) fulfilled the 6-Steps of HR completely. The median score for student in 3rd,4th and 5th year students were (6.37),(7.16) and(7.45) respectively while interns scored(7.36) and residents(7.49) with a significant difference (P=0.016).Surprisingly, junior residents scored better than seniors(P=0.001). Participates with previous training scored better than those who weren’t with a mean score of(7.40) compared to(6.27)(P=<0.001).


The quality of HR practiced by students, interns, and residents in KKUH seems to lack the full and appropriate coverage of all hand surfaces and might serve as a medium for HCAI revealing a major gap that future effort shall emphasize on.


Medical intern graduated from King Saud University College of Medicine , Riyadh, Saudi Arabia

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