Start education about hand hygiene at an early age with a musical mnemonic device, and it could even help healthcare professionals sing a different tune about handwashing, researchers said.
After handwashing while singing a song outlining the World Health Organization’s hand hygiene technique, there were signs of decreased microbial burden on hands, reported Nisha Thampi, MD, of Children’s Hospital of Eastern Ontario in Canada, and colleagues, in The BMJ‘s annual Christmas edition, in which the journal publishes lighthearted articles containing real science.
Thampi and colleagues noted previous studies examining the effect of school-based hand hygiene interventions on, for example, school absenteeism and infection, but also the lack of literature on how hand hygiene is taught to children. They added that “musical mnemonics” could be a solution.
“Learning through song lyrics, where the instructions are stated before completion of each step, has been shown to produce quicker acquisition of novel skills compared with prose self instruction,” the authors wrote.
After reviewing 15 videos online about handwashing, they found none that showed the six-step technique using a song mnemonic in the recommended handwashing duration of 20-30 seconds. So, the authors decided to create one of their own, with lyrics developed in collaboration with their target audience of young children, to the tune of “Brother John (Frére Jacques)”:
Scrub your palms between the fingers
Wash the back (one hand), wash the back (other hand)
Twirl the tips (one hand) around (other hand), scrub them upside down
Thumb attack (one thumb!), thumb attack (other thumb!)
The authors noted that the last line should be sung “with gusto,” and each line should be repeated as necessary to complete each step.
To test whether or not this could produce results amongst themselves, they applied fluorescent marking on hands to “indicate presence of microbial flora.” After performing all the hand hygiene techniques outlined in the song, they saw “a notable absence of fluorescent marking” on most of the palms, back of the hands, and fingertips, though with traces in the nail bed.
If the WHO hand hygiene technique can be taught via a 20-second song, this could have broader implications for school-based public health campaigns, Thampi and colleagues asserted. They added that they planned to test this strategy in a classroom setting.
And it might even have healthcare professionals singing along.
“Given the longstanding clinical challenges of compliance with the six-step technique, there is also potential for this musical mnemonic to be adopted in the healthcare setting,” the authors noted.
The authors disclosed no conflicts of interest.