Association for Professionals in Infection Control and Epidemiology Annual Conference
Association for Professionals in Infection Control and Epidemiology Annual Conference
June 13, 2016
1 min read

Images triggering disgust improve hand hygiene compliance at hospital

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Hand hygiene compliance rates improved among health care workers at a Detroit hospital after they were shown images of bacterial growth similar to the levels of contamination on their own skin, according to study results presented at the Association for Professionals in Infection Control and Epidemiology annual conference.

Ashley Gregory, MLS, infection prevention specialist for the Henry Ford Health System, and colleagues said they were inspired by a study published in 2014 in Lancet Global Health in which an intervention in India based on emotional drivers — skits, an animated film, a public pledging ceremony — was more effective than traditional messaging at increasing handwashing with soap.

For their study, Gregory and colleagues compiled a book of bacterial culture images that were meant to stir a feeling of disgust when shown to hospital staff. They picked four units with low hand hygiene compliance rates and carried out 10 interventions on each unit for 2 months. The interventions consisted of performing adenosine triphosphate testing (ATP) on the hands of the health care workers, then showing them what a culture of a similar reading looked like.

Each unit saw an increase in hygiene compliance rates of at least 11 percentage points. Compliance rates in the four units were 47.4%, 50%, 33.3 % and 50% before the study. After 10 weeks, those rates increased to 58.3%, 68.4%, 80.9% and 68.8 %.

“The implication for clinicians is that hand hygiene is more than just washing their hands before and after contact with their patients,” Gregory told Infectious Disease News. “Their stethoscope, mobile phone and other devices can become contaminated and thus can contaminate their hands at any given point in their interaction.” – by Gerard Gallagher


Biran A, et al. Lancet Glob Health. 2014;doi:10.1016/S2214-109X(13)70160-8.

Gregory A, et al. Abstract 1200-01. Presented at: Annual Conference of the Association for Professionals in Infection Control and Epidemiology; June 11-13, 2016; Charlotte, N.C.

Disclosure: The researchers report no relevant financial disclosures. 

Figure 1. A bacterial culture representing the contamination of a health care worker’s hand.

Source: Henry Ford Hospital

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