introduction & methods.(please paraphrase the intro and methods, as they are previous year’s student’s work + method might be slightly different like timing so please change them)

introduction & methods.(please paraphrase the intro and methods, as they are previous year’s student’s work + method might be slightly different like timing so please change them)

Please write conclusion along the line

1.soap or water only washing are both effective
2.based on previous studies, soap washing is more effectvive than water alone, but based on our data, it suggest differently
3. time spent on washing have no releavne in reduction of bacteria with or without soap
4.hand sanitsation with the use of soap and proper hand drying should be done before and after and between each patient to reduce unnecessary health risk.

lastly i have attached a reference for the use) and the marking guide.

Epidemiol. Infect. (1997), 119, 319?325. Printed in the United Kingdom # 1997 Cambridge University Press
Residual moisture determines the level of touch-contact- associated bacterial transfer following hand washing
D. R. PATRICK, G. FINDON ??? T.E.MILLER*
Department of Medicine, University of Auckland, Auckland, New Zealand
(Accepted 5 August 1997)
SUMMARY
We report here a new and critical determinant of the e?ectiveness of hand hygiene procedures, namely the amount of residual moisture left on the hands after washing and drying. When samples of skin, food and utilities were touched with wet, undried hands, microbial numbers in the order of 68000, 31000 and 1900 respectively translocated to these representative surfaces. Bacterial numbers translocating on touch contact decreased progressively as drying with an air or cloth towel system removed residual moisture from the hands. A 10 s cloth towel?20 s air towel protocol reduced the bacterial numbers translocating to skin, food and utilities on touch contact to 140, 655 and 28 respectively and achieved a 99?8, 94 and 99% reduction in the level of bacterial translocation associated with wet hands. Careful hand drying is a critical factor determining the level of touch-contact-associated bacterial transfer after hand washing and its recognition could make a signi?cant contribution towards improving handcare practices in clinical and public health sectors.
INTRODUCTION
An awareness that an individual?s hands can be a source of cross infection and a vehicle for the transmission of infectious disease has remained un- disputed since Semmelweiss in Europe [1]and Wendall Holmes in the United States [2] clearly demonstrated the e?cacy of hand washing in the prevention of puerperal sepsis and its associated mortality. There is no shortage of scienti?c papers in the medical, nursing and surgical literature on the subject of hand hygiene and infection control but the emphasis has been on the e?ect of hand disinfection and washing on the indigenous or experimentally introduced skin mi- crobial ?ora. As a result, hand hygiene has become synonymous with practices and products that reduce microbial numbers on the hands. In the course of studying hand hygiene practices in relation to touch contamination induced peritonitis in
* Author for correspondence: Dr Thomas Miller, Department of Medicine, Auckland Hospital, Private Bag 92-024, Auckland, New Zealand.
patients undergoing peritoneal dialysis, we made the serendipitous discovery that the single most important determinant of the number of micro-organisms trans- locating from an individual?s ?ngers to the dialysis bag exchange equipment was the residual moisture remaining on the hands after washing [3]. When a patient?s hands were carefully dried, bacterial con- tamination of the plastic connecting devices was very low. Damp hands however facilitated the transfer of many thousands of micro-organisms to the connecting devices and ultimately, into the peritoneal cavity. These observations established a clear association between residual moisture on the hands and bacterial translocation with touch contact but the relationship was not determined in quantitative terms. In the current investigation we set out to quantify the e?ect of hand drying on touch-contact-associated translocation of micro-organisms from ?ngers to surfaces representing skin, food and clinical utilities. With this information available, we were able to devise a practical hand drying procedure that reduced touch contact contamination to a minimum. The
320 D. R. Patrick, G. Findon and T. E. Miller

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