Monitoring the effectiveness of surgical handwashing in healthcare workers of a fourth level operating room using bioluminescence assays

This article is a product of the project "Effectiveness of the handwashing technique in workers of the surgical team at the Hospital Universitario Clinica San Rafael in the year 2021", developed by Fundacion Universitaria del area Andina and Hospital Universitario Clinica San Rafael.Aim: To assesses the effectiveness of surgical handwashing (S-HW) in healthcare workers (HCWs) in terms of organic material and bacteria elimination by means of bioluminescence assays.Methods: 62-HCWs were subjected to bioluminescence analyses to determine adenosine triphosphate (ATP) and colony forming units (CFU) of Enterobacteriaceae (EB) and Escherichia coli (E. coli) before and after S-HW. A checklist to evaluate adherence to hand hygiene (HH) protocol was implemented.Results: ATP before HH (510.9/RLU) was reduced after S-HW (54.6/RLU), evidencing a significant decrease (p=0.001). Regarding the bacteria, 26.6/CFU and 4/CFU for EB and E. coli were reported before S-HW, respecti-vely. After S-HW, CFU decreased for EB (21.8/CFU) and E. coli (3.5/CFU) without showing a significant reduction (p=0.679). Low ATP did not evidence a direct relation with EB (p=0.082) and E. coli (p=0.680) reduction. Surgical instrument professionals (p=0.001), general surgeons (p=0.001), residents (p=0.017), orthopedists (p=0.029) and otolaryngologists (p=0.029) evidenced a reduction in ATP after S-HW. Factors such as S-HW direction, surgical soap, number of times and time of S-HW implemented showed a statistically significant difference in reduction of ATP, but not in CFU.Conclusion: Although there was a reduction in elimination of ATP, there was no evidence of a decrease in bacteria. This finding not only helped identify potential errors in S-HW processes, but also led to the generation of strategies to improve HH to prevent healthcare-associated infections. Limitation of the study: It was not possible to analyze other kinds of bacteria present on HCWs' hands such as S. aureus, Pseudomonas aeruginosa, Klebsiella, among others.