Evaluation of the Efficiency of Hand Hygiene Technique with Hydroalcoholic Solution by Image Color Summarize

Abstract

Background and Objectives: The HH (hand hygiene) technique is relatively simple. Even so, in practice there are still non-conformities regarding this aspect. Lack of knowledge or lack of compliance can be reasons for non-adherence with HH techniques. In this context, the purpose of this study was to follow the realization of the hand-washing technique with hydroalcoholic solution, applied before and after receiving the HH recommendations. Materials and Methods: A descriptive, cross-sectional study was conducted from May 2022 to June 2022. Students from a second year dental medicine class teaching in French 2021/22 "Grigore T. Popa" University of Medicine and Pharmacy in Iasi were included in the study. The approval of the ethics commission was received: No. 184/05.05.2022. The study was conducted in two stages. In the first stage, HH was performed without any recommendation. In the second stage, the antiseptic hand rubbing technique was presented following the WHO recommendations. The fluorescent Fluo-Add solution, Wood lamp for dermatology (4 × 5.5 W ultraviolet tubes with a wavelength of 360 nm), and photo camera were used. Subjects performed their HH movement before and after receiving instructions according to WHO. Images were initially taken from the backhand and palm and were finally analyzed with Image Color Summarizer. The data were analyzed by the Mann-Whitney U Test, t-test paired samples using IBM-SPSS version 26 (IBM, Armonk, NY, USA), and p ≤ 0.05 was considered statistically significant. Results: After analyzing the images, there were 70 subjects, 45.7% (32) female and 54.33% (38) male. Final average covered area of backhand was 60.89% (±17.17), 28.84:86.11, compared to 52.07% (±17.04), 9:85.23. Final average covered area for palm was 69.91% (±13.5), 31.61:93.41 compared to 59.74% (±16.64), 26.13:92.72. No statistical significance was obtained by gender. Conclusions: The study showed an improvement in hand hygiene technique without highlighting gender differences.

Keywords: control infection; fluorescence; hand hygiene; hydroalcoholic-solution.

Figure 1

Cluster colors, sized by number of pixels: Image Cluster Partitions Pixels of the image. The image represents initial backhand image. The coverage of the hands with fluorescent solution was evaluated by the brightest color, (bright) respectively, of 18.83% compared to the uncovered surface of 28.98%. In the final calculation, the darkest image of 52.19% was removed. By applying the simple rule of three, a percentage of 100% was calculated for the surface covered with fluorescent solution and a percentage of 100% for the surface not covered with fluorescent solution. Thus, after applying this algorithm, the final percentage of covered area was 39.39% and the uncovered area was 60.61%.

Figure 2

Cluster colors, sized by number of pixels: Image Cluster Partitions Pixels of the image. The image represents final backhand image. The border is the color of the cluster as calculated by the average value of its pixels. The coverage of the hands with fluorescent solution was evaluated by the brightest color, (bright) respectively, of 26.75% compared to the uncovered surface of 24.26%. In the final calculation, the darkest image of 48.99% was removed. By applying the simple rule of three, a percentage of 100% was calculated for the surface covered with fluorescent solution and a percentage of 100% for the surface not covered with fluorescent solution. Thus, after applying this algorithm, the final percentage of covered area was 52.44% and the uncovered area was 47.66%.

Figure 3

Frequency of data obtained for covered palm: (a) initial; (b) final.

Figure 4

Frequency of data obtained for covered backhand: (a) initial; (b) final.

Figure 5

Independent-Samples Mann–Whitney U Test—covered backhand across sex: (a) initial; (b) final.

Figure 6

Independent-Samples Mann-Whitney U Test—uncovered backhand across sex (a) Initial; (b) Final.

Figure 7

Independent-Samples Mann–Whitney U Test—covered palm across sex: (a) initial; (b) final.

Figure 8

Independent-Samples Mann–Whitney U Test—uncovered palm across sex: (a) initial; (b) final.