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VOLUME 18 , ISSUE 12 ( December, 2017 ) > List of Articles


Impact of Educational Intervention for Hand Hygiene on Dental Students’ Knowledge, Attitude, and Bacterial Contamination Level on Hands

Hanadi Lingawi, Yahia Maher, Ibtesam Afifi

Citation Information : Lingawi H, Maher Y, Afifi I. Impact of Educational Intervention for Hand Hygiene on Dental Students’ Knowledge, Attitude, and Bacterial Contamination Level on Hands. J Contemp Dent Pract 2017; 18 (12):1164-1172.

DOI: 10.5005/jp-journals-10024-2193

Published Online: 01-08-2016

Copyright Statement:  Copyright © 2017; The Author(s).



The present study aimed to investigate the impact of the educational intervention for hand hygiene (HH) on knowledge, attitude, and mean colony-forming bacterial counts and type of bacteria on hands of undergraduate dental students.

Materials and methods

A total of 86 dental students from different clinical grades were included in the study. They were divided into two groups, group I (55 students) received onetime educational session for HH at the start of the academic year and group II (31 students) received an extra reenforcement session 6 months later. After 2 weeks of reenforcement session, a self-administrated questionnaire was directed to all participants assessing their knowledge and attitude about HH. Fingertip prints of the five fingers of the dominant hand from every participant were pressed onto blood agar plates in triplets at the same clinical session, before and after HH. Bacterial colony-forming units (CFUs) on each plate were recorded and identified microbiologically.


The overall scores of knowledge and attitude showed higher levels in group II than in group I with nonsignificant differences between both groups as regards knowledge and significant differences (p < 0.05) as regards attitude. Mean CFUs showed extremely significant differences (p ≤ 0.000) between 2nd and 3rd counts and between 1st and 2nd counts except for students of group I where the difference was only significant (p ≤ 0.05). Normal bacterial flora was identified in 94.9% of the plates (92.2% coagulase-negative Staphylococci and 2.7% Micrococcus). Potentially pathogenic bacteria isolated from the other plates were Klebsiella pneumonia, Pseudomonas spp., and spore-forming aerobic nonhemolytic Bacilli.


Reenforcement session had a positive impact on HH knowledge, attitude, and reduction of bacterial CFUs.

Clinical significance

Continuous education with frequent training sessions is recommended to reinforce HH compliance and reduce cross-contamination.

How to cite this article

Lingawi H, Maher Y, Afifi I. Impact of Educational Intervention for Hand Hygiene on Dental Students’ Knowledge, Attitude, and Bacterial Contamination Level on Hands. J Contemp Dent Pract 2017;18(12):1164-1172.

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  1. Role of intensive care unit environment and health-care workers in transmission of ventilator-associated pneumonia. J Infect Dev Ctries 2010 Jun;4(5):282-291.
  2. Guidelines for infection control in dental health-care settings-2003. MMWR Recomm Rep 2003 Dec;52(RR17):1-61.
  3. Hand hygiene practices in a dental teaching center: measures and improve. Eur J Dent 2014 Oct-Dec;8(4):481-486.
  4. Improving adherence to hand hygiene practice: a multidisciplinary approach. Emerg Infect Dis 2001 Mar-Apr;7(2):234-240.
  5. Videos in clinical medicine. Hand hygiene. N Engl J Med 2011 Mar;364(13):e24.
  6. Knowledge, attitude, and practice of hand hygiene among dentists practicing in Bangalore city-a cross-sectional survey. J Int Soc Prev Community Dent 2014 Sep-Dec;4(3):159-163.
  7. Bacterial contamination of the hands of hospital staff during routine patient care. Arch Intern Med 1999 Apr;159(8):821-826.
  8. Hand hygiene: back to the basics of infection control. Indian J Med Res 2011 Nov;134(5):611-620.
  9. An observational study of the hand hygiene initiative: a comparison of preintervention and postintervention outcomes. BMJ Open 2013 Jan;3(5):E003018.
  10. Students hand hygiene knowledge, hand contamination and practice of Italian nursing and medical students. Epidemiol Biostat Public Health 2014 Dec;11(4):1-9.
  11. Impact assessment of educational intervention among private dental practitioners about infection control practices in district Peshawar. Pak J Med Res 2015 Jul-Sep;54(3):78-83.
  12. Knowledge, attitude, and practice of Iranian dental students of the standard hand washing technique: an interventional study. J Med Educ 2015 Spring;14(2):64-69.
  13. Dental student hand hygiene decreased with increased clinical experience. J Surg Educ 2016 May-Jun;73(3):400-408.
  14. Bacteria decontamination after different hand hygiene procedures in dental assistants during patient care. M Dent J 2016 Feb;36:1-12.
  15. Knowledge, attitude, and performance of nurses towards hand hygiene in hospitals. Glob J Health Sci 2016 Aug;8(8):57-65.
  16. Competency assessment for infection control in the undergraduate dental curriculum. Eur J Dent Educ 2007 Aug;11(3):148-154.
  17. Infection control practices among undergraduate students from a private dental school in India. Rev Odonto Ciênc 2009 Mar;24(2):124-128.
  18. Knowledge of hand hygiene in undergraduate medical, dental, and nursing students: a cross-sectional survey. J Family Med Prim Care 2015 Oct-Dec;4(4):582-586.
  19. Prevalence of hand hygiene awareness among medical and dental students in a teaching hospital. Indian J Microbiol Res 2016;3(3):262-265.
  20. Hand hygiene amongst dental professionals in a tertiary dental clinic. Afr J Clin Exp Microbiol 2011 Jan;12(1):9-14.
  21. The fundamental role of educational intervention on improving health care workers' knowledge, attitude and practice towards infection control precautions. Int J Infect Control 2016 Aug;12(3):1-11.
  22. Gender differences in hand hygiene among Saudi nursing students. Int J Infect Control 2015;11(4):1-13.
  23. Health care workers' hand contamination levels and antibacterial efficacy of different hand hygiene methods used in a Vietnamese hospital. Am J Infect Control 2014 Feb;42(2):178-181.
  24. Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 2004 Oct;17(4):863-893.
  25. Study on the bacterial isolates from hand swab samples of health care workers and antibiotic sensitivity pattern, in a tertiary care hospital, Lucknow. Int J Adv Res 2017 Mar;5(3):2367-2373.
  26. Bacterial and fungal contamination of dental hygienists' hands with and without finger rings. Acta Stomatol Naissi 2013 Jun;29(67):1260-1264.
  27. Survival on skin and surfaces of epidemic and non-epidemic strains of Enterobacteria from neonatal special care units. J Hosp Infect 1995 Mar;29(3):201-208.
  28. Distribution and transmission of Pseudomonas aeruginosa and Burkholderia cepacia in a hospital ward. Pediatr Pulmonol 1996 Feb;21(2):90-100.
  29. Endemic Pseudomonas aeruginosa infection in a neonatal intensive care unit. N Engl J Med 2000 Sep;343(10):695-700.
  30. Contamination of healthcare workers' hands with bacterial spores. J Infect Chemother 2016 Aug;22(8):521-525.
  31. Evaluation of the antimicrobial efficacy and safety of pure hands herbal hand sanitizer in hand hygiene and on inanimate objects. Antiseptic 2004 Jan;101(2):55-57.
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