A systematic review to evaluate the evidence base for the World Health Organization's adopted hand hygiene technique for reducing the microbial load on the hands of healthcare workers

Background: Effective hand hygiene prevents healthcare-associated infections. This systematic review evaluates the evidence for the World Health Organization's (WHO) technique in reducing the microbial load on the hands of healthcare workers (HCWs). Methods: This study was conducted in accordance with Joanna Briggs Protocol 531. Index and free-text terms for technique, HCW, and microbial load were searched in CINAHL, Medline, Web of Science, Mednar, Proquest, and Google Scholar. Inclusion criteria were articles in English that evaluated the WHO 6-step hand hygiene technique for healthcare staff. Two reviewers independently performed quality assessment and data extraction. Results: All 7 studies found that the WHO technique reduced bacterial load on HCW hands, but the strongest evidence came from 3 randomized controlled trials, which reported conflicting evidence. One study found no difference in the effectiveness of the WHO 6-step technique compared to the Centers for Disease Control and Prevention's 3-step technique (P =.08); another study found the WHO 6-step technique to be more effective (P =.02); and the third study found that a modified 3-step technique was more effective than the 6-step technique (P =.021). Conclusions: This review provides evidence of the effectiveness of the WHO technique but does not identify the most effective hand hygiene technique. Questions to be addressed by further research are identified. Meanwhile, current practices should continue

Cost-effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts: economic evaluation alongside a randomised controlled trial (EVerT trial)

Background Plantar warts (verrucae) are extremely common. Although many will spontaneously disappear without treatment, treatment may be sought for a variety of reasons such as discomfort. There are a number of different treatments for cutaneous warts, with salicylic acid and cryotherapy using liquid nitrogen being two of the most common forms of treatment. To date, no full economic evaluation of either salicylic acid or cryotherapy has been conducted based on the use of primary data in a pragmatic setting. This paper describes the cost-effectiveness analysis which was conducted alongside a pragmatic multicentre, randomised trial evaluating the clinical effectiveness of cryotherapy versus 50% salicylic acid of the treatment of plantar warts. Methods A cost-effectiveness analysis was undertaken alongside a pragmatic multicentre, randomised controlled trial assessing the clinical effectiveness of 50% salicylic acid and cryotherapy using liquid nitrogen at 12 weeks after randomisation of patients. Cost-effectiveness outcomes were expressed as the additional cost required to completely cure the plantar warts of one additional patient. A NHS perspective was taken for the analysis. Results Cryotherapy costs on average £101.17 (bias corrected and accelerated (BCA) 95% CI: 85.09-117.26) more per participant over the 12 week time-frame, while there is no additional benefit, in terms of proportion of patients healed compared with salicylic acid. Conclusions Cryotherapy is more costly and no more effective than salicylic acid

Inter Professional Learning

GCU staff simulate discussion of issues arising in IP

Practice-based learning and the impacts of COVID-19: doing it for real?

This is the fifth article in a series exploring interprofessional education during the COVID-19 pandemic. This article focuses on the experiences and adaptations employed in relation to practicebased learning and placement provision. Forming an integral part of many professional programmes, changes in provision and approaches to practice-based learning and placements will be explored, drawing on theory and findings from existing literature and illustrated with case study reports. Opportunities for innovation, the challenges for incorporating interprofessional practice learning and evidenceinformed guidance for future practice will be considered