Hand hygiene in students of medical school during training activities: knowledge, behaviour and prevalence of bacterial contamination.

The aim of the study was to evaluate knowledge, attitude and on-field practices concerning hand hygiene of undergraduate students attending the university hospital of Modena. The prevalence of bacterial contamination of their hands at entry to ward and at exit was also evaluated. Swab samples were analysed for total bacteria count at 37°C, Staphylococcus aureus, Pseudomonas aeruginosa and enterococci. At the end of the morning activity, participant students filled a questionnaire on personal data, activities, opportunities, opinion and compliance of hand hygiene. Higher total counts were measured at entrance compared to exit in both medical and nursing students, but the last group exhibited a stronger reduction due to higher compliance with hand-hygiene practices. Alcohol gel was the preferred procedure, and showed also a higher efficacy in reducing hand contamination. Contacts with stethoscopes and case history were those associated with higher levels of total bacterial counts as no hand hygiene followed those activities. No pathogen was recovered with the exception of two samples colonised by Staphylococcus aureus. Knowledge on hand hygiene was in general good, but should be implemented for students becoming doctors.