Teaching the World Health Organization’s How to Handrub and Five Moments for Hand Hygiene in a health care delivery course at a new school of pharmacy

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To implement and evaluate instruction of hand rubbing with alcohol-based products using the World Health Organization (WHO) guidelines and indications.


Newly matriculated P1 students were required to attend a 75-minute class during which an instructor presented hand hygiene in the context of professionalism and the incidence of health care-associated infections and community-acquired antimicrobial-resistant infections in pharmacy practice settings. Students then practiced the eight-step World Health Organization (WHO) method using a WHO infographic and alcohol-based hand sanitizer and watched a New England Journal of Medicine video to reinforce skill instruction and to introduce the WHO indications for hand hygiene.


Individual hand rubbing skill was assessed by individual observation using a ten-point rubric. Knowledge was tested by exam. Change in student attitudes and motivation to perform hand hygiene were measured by survey. All students (n = 77) demonstrated mastery of WHO hand rubbing. Correct answers to exam questions ranged from 83% to 100% per question. Student attitudes and motivation to perform hand hygiene increased significantly.


Mastery of WHO hand rubbing can be achieved with limited class time. This skill may protect both students and patients from health care-associated infections and community-acquired infections while providing a strong visual demonstration of professionalism to patients and other providers.



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