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 Table of Contents  
Year : 2018  |  Volume : 6  |  Issue : 3  |  Page : 93-94

ABC's of hand hygiene: An aid to improve adherence

1 Clinical Haematology and Stem Cell Transplantation, Christian Medical College and Hospital, Ludhiana, Punjab, India
2 Paediatric Critical Care, Jawaharlal Institute of Post Graduate Medicine and Research, Puducherry, India

Date of Web Publication4-Mar-2019

Correspondence Address:
Dr. Chepsy C Philip
Christian Medical College and Hospital, Ludhiana - 141 008, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpsic.jpsic_21_18

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How to cite this article:
Philip CC, Abraham S, Mathew A, John M J. ABC's of hand hygiene: An aid to improve adherence. J Patient Saf Infect Control 2018;6:93-4

How to cite this URL:
Philip CC, Abraham S, Mathew A, John M J. ABC's of hand hygiene: An aid to improve adherence. J Patient Saf Infect Control [serial online] 2018 [cited 2023 Jun 7];6:93-4. Available from: https://www.jpsiconline.com/text.asp?2018/6/3/93/253386

Healthcare-associated infections are a serious global problem. It can be transmitted through direct and indirect contact. Transmission through the contaminated hands of the healthcare worker is the most common pattern. In the absence of appropriate hand hygiene action, the longer the care, higher the degree of contamination of the hands.[1]

Hand hygiene is the primary measure proven to be effective in preventing healthcare-associated infection and the spread of antimicrobial resistance.[2] Handwashing is a simple and effective way of hand hygiene. Deficiencies in handwashing lead to poor decontamination.

Despite the proven evidence, guidelines and efforts of global agencies including the WHO, there appears to be limitations and many barriers to effective handwashing.[1] Lack of knowledge, experience and education are among many recognised barriers to effective hand hygiene. Additional tools are required to aid healthcare worker education. In the developing world where there is an existing burden of infection and antimicrobial resistance,[3],[4] it will be useful to augment the efforts to improve hand hygiene.

Mnemonics are recognised useful aids to facilitate recall.[5],[6] Their use in healthcare to improve translation of knowledge and retrieve procedural items has been recognised to be effective.[7],[8] Similar to the sequence of airway, breathing and circulation (ABC) in trauma care and cardiopulmonary resuscitation (CPR), the use of ABC in handwashing {[Figure 1]: A-Accept and Apply; B-Backhand; C-Clasp; D-Dock; E-Encircle the thumbs; F-Rub the Fingertips]} could be utilised as a tool to aid education. This traces the appropriate handwash steps from A to F, possibly improving procedural recall by relating each step in the procedure to the alphabetical order from A through F. The ABC in CPR is being introduced into community through schools to augment the impact of basic life support and save more lives.[9],[10] It might have a similar effect if the hand wash mnemonic could be introduced in the community and schools to supplement the efforts to improve hand hygiene, though its utility will have to be tested in a real-life setting.
Figure 1: A to F of hand washing

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We propose the incorporation of the “ABC” mnemonic to the health-care workers education to make handwashing simpler and effective. It is also a possibility that extending its use in the community could help enhance the efforts against transmission of infection.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. WHO Guidelines on Hand Hygiene in Health Care. World Health Organization; 2009. Available from: http://www.whqlibdoc who int/publications/2009/9789241597906_engpdf. [Last accessed on 2018 Dec 06].  Back to cited text no. 1
Toney-Butler TJ, Carver N. Hand, Washing (Hand Hygiene). In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2018. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470254/. [Last accessed on 2018 Dec 09].  Back to cited text no. 2
Bhutta ZA, Salam RA, Das JK, Lassi ZS. Tackling the existing burden of infectious diseases in the developing world: Existing gaps and the way forward. Infect Dis Poverty 2014;3:28.  Back to cited text no. 3
Rosenthal VD. Health-care-associated infections in developing countries. Lancet 2011;377:186-8.  Back to cited text no. 4
Blocki J, Komanduri S, Cranor L, Datta A. Spaced Repetition and Mnemonics Enable Recall of Multiple Strong Passwords; 2014.  Back to cited text no. 5
Young KW, Ng P, Kwok T, Cheng D. The effects of holistic health group interventions on improving the cognitive ability of persons with mild cognitive impairment: A randomized controlled trial. Clin Interv Aging 2017;12:1543-52.  Back to cited text no. 6
Kushner R. Taking a Weight History – Using Mnemonics to Learn a Missing Skill in Medical Education. Medical Education; 29 November, 2017. Available from: https://www.mededpublish.org/manuscripts/1338. [Last accessed on 2018 Dec 09].  Back to cited text no. 7
Clay-Williams R, Colligan L. Back to basics: Checklists in aviation and healthcare. BMJ Qual Saf 2015;24:428-31.  Back to cited text no. 8
Fernandez CJ, Caminos CB, Eito JF, Diez DR, Zabaleta MO, Olcoz SM. Teacher evaluation of a training courses in basic life support – The ABC that saves lives program. Resuscitation 2018;130:e73.  Back to cited text no. 9
Fernandez CJ, Caminos CB, Diez DR, Velilla N, Castro M, Miranda S. School directors view on CPR training and curricular inclusion in primary schools in Navarra, Spain. Resuscitation 2015;96:88.  Back to cited text no. 10


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