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NCT Number: NCT04187040

SIMPLIFY the Hand Hygiene Procedure - Three Steps Versus Six Steps for Performing Hand Hygiene (SIMPLIFY Study)

Hand hygiene is one of the most important measures to prevent healthcare associated infections. A hand hygiene technique consisting of three steps may be superior to the 6-step technique outlined by the World Health Organization (WHO) in terms of compliance with both indications and technique. Therefore, the aim of this study is to compare compliance with hand hygiene indications and technique between a 3-step and the 6-step technique for applying hand rub in an international multicenter cluster randomized trial.

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Key information

Conditions

Hand Hygiene

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Hand hygiene is one of the most important measures to prevent transmission of pathogens between healthcare workers and patients, and ultimately, healthcare-associated infections. However, compliance with both hand hygiene indications and technique (outlining the steps for applying hand rub to ensure coverage of all surfaces of the hands) remains insufficient at most institutions worldwide. It was previously demonstrated that a hand hygiene technique consisting of three steps is superior to the 6-step technique outlined by the World Health Organization (WHO) in terms of compliance with both indications and technique in a single center study. Furthermore, the 3-step technique was non-inferior regarding microbiological efficacy in two experimental studies and during daily clinical practice. To further investigate the external validity and generalizability of these findings to different settings, this study compares both compliance with hand hygiene indications and technique between the 3-step and the 6-step technique for applying hand rub in an international multicenter cluster randomized trial.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Health Care Workers (HCW) working at the randomized wards during the pre-defined timeframe

Exclusion criteria

Individuals, who are no HCWs

Treatment and study plan

Study intervention: 3-step hand hygiene technique

Procedure

3-step hand hygiene technique:

  • Covering all surfaces of the hands (based on own judgement)
  • Rotational rubbing of fingertips in the palm of the alternate hand
  • Rotational rubbing of both thumbs

Control intervention: 6-step hand hygiene technique

Procedure

6-step hand hygiene technique (according to the WHO Guidelines on Hand Hygiene in Health Care, First Global Patient Safety Challenge):

  • Rubbing hands palm to palm
  • Palm to palm with fingers interlaced
  • Right palm over left dorsum with interlaced fingers and vice versa
  • Back of fingers to opposing palms with fingers interlocked
  • Rotational rubbing of left thumb clasped in right palm and vice versa
  • Rotational rubbing backwards and forwards with clasped fingers of right hand in left palm and vice versa

Primary outcomes

  1. Compliance with hand hygiene indications

    Time frame: Up to one year

    Compliance with the five hand hygiene indications defined by the WHO:

    • before touching a patient
    • before clean/aseptic procedures
    • after body fluid exposure risk
    • after touching a patient
    • after touching patient surroundings

  2. Compliance with the assigned hand hygiene technique

    Time frame: Up to one year

    Compliance with the assigned technique, defined as performance of the proposed three steps in the intervention group and of all six steps in the control group.

Secondary outcomes

  1. Compliance with performance of the two steps for applying hand rub to the thumbs and the fingertips

    Time frame: Up to one year

    Compliance with performance of the two steps for applying hand rub to the thumbs and the fingertips, which are part of both the 3-step and the 6-step technique for applying hand rub.

  2. Duration of the hand hygiene action

    Time frame: Up to one year

    Duration of the hand hygiene action, the time spent for the application of hand rub will be measured and compared between the two assignments.

Study contacts

Contact information is provided by the study sponsor or research team.

Sarah Tschudin Sutter, Prof.Dr.med.

CONTACT

[email protected]

+41 61 328 68 10

Sponsors and collaborators

Lead sponsor

University Hospital, Basel, Switzerland

Other

Registry information

Official study title

SIMPLIFY the Hand Hygiene Procedure - Three Steps Versus Six Steps for Performing Hand Hygiene - an International Multicenter Cluster Randomized Trial (SIMPLIFY Study)

Acronym: SIMPLIFY

Important dates

Study start
2026
Primary completion
2026
Study completion
2026
First posted
Dec 5, 2019
Registry last updated
Jun 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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