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Article Abstract
Background: Hand hygiene (HH) is essential for infection prevention in healthcare, but the quality of its performance, meaning how well it is done, receives much less attention than compliance. This review examines how HH technique is assessed and can be improved among healthcare providers.
Methods: Following PRISMA guidelines, six databases were searched through May 15, 2025. Studies assessing HH performance quality in healthcare were included. Quality indicators included technique completeness, product volume, and duration. Study selection, data extraction, and risk of bias assessments were performed independently by two reviewers.
Results: Forty studies met inclusion criteria. Despite compliance rates, ranging from 23.5% to 93.2%, proper technique was often lacking. Few HH events followed all recommended steps, and frequently missed areas included fingertips, thumbs, and wrists. Alcohol-based hand rubs (ABHR) outperformed soap and water in quality and coverage. Interventions such as real-time feedback, UV markers, and augmented reality tools improved technique temporarily, though sustained improvement was rare. Educational interventions showed mixed long-term results.
Conclusions: HH performance quality remains suboptimal even with high compliance. Future efforts should prioritize technique-focused training, innovative feedback, and simplified protocols to enhance hand hygiene quality in clinical practice.
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| http://dx.doi.org/10.1016/j.ajic.2025.08.025 | DOI Listing |
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