Hand Hygiene RCT A Pragmatic Randomized Controlled Trial of 6-Step vs 3-Step Hand Hygiene Technique in Acute HospitalCare in the United Kingdom

Project Team 

Chief Investigator: Professor Jacqui Reilly 

GCU Co-investigators: Professor Lesley Price, Dr Sue Lang, Kirsty Skinner

External Collaborators: Professor Chris Robertson (University of Strathclyde), Professor Francine Cheater (University of East Anglia), Dr Angela Chow(Tan Tock Seng Hospital, Singapore)

Funder: The Scottish Infection Research Network

Dates: Completed


Hand hygiene is argued to be the most important intervention in preventing healthcare-associated infection. Despite this there is limited evidence to support hand hygiene techniques, and compliance with hand hygiene remains suboptimal. There is little point in getting the opportunity, or the “5 Moments,” correct for hand hygiene if a technique effective in reducing the bacterial load on the hand thereafter is not evident.


This study aimed to evaluate the microbiologic effectiveness of two hand hygiene techniques used internationally on residual bacterial load of healthcare workers.


To evaluate the microbiologic effectiveness of the World Health Organization’s 6-step and the Centers for Disease Control and Prevention’s 3-step hand hygiene techniques using alcohol-based handrub.


Reilly J, Price L, Lang S, RobertsonC, Cheater F, Skinner K & Chow A (2016) Pragmatic randomized controlled trial of 6-step vs 3-step hand hygiene technique in acute hospital care in the United Kingdom. Infection Control and Hospital Epidemiology Infection Control & Hospital Epidemiology 37(6) 661 – 666  

Price L, Melone L, Cutajar E, Blane L, Gozdzielewska L, Young M, McAloney-Kocaman K, Reilly J. Investigating the effect of preparation for and participation in a hand sanitizing relay on nursing students’ ability to recall the WHO six-step hand hygiene technique. American Journal of Infection Control.