Comparison of 90 seconds and 180 seconds surgical handwashing times in preventing Central line associated Bloodstream infections in the ED. A randomized control study. CLAPPED HANDS trial (CLABSI Prevention in ED with Hand hygiene durations)

Central line-associated bloodstream infections (CLABSI) are a leading cause of morbidity, mortality, and healthcare-associated costs in hospitals worldwide. The emergency department (ED) is a high-risk environment for CLABSI due to the high volume of patients, urgent insertion of central lines, and limited time for healthcare workers to adhere to rigorous infection control practices. Surgical handwashing is a cornerstone of CLABSI prevention, and the World Health Organization (WHO) and Centre for Disease Control and Prevention (CDC) recommend a handwashing time of 2 to 5 minutes to reduce microbial load and prevent infections.

However, the practicality of adhering to this duration in fast-paced ED environments has raised concerns. ED healthcare workers often face time constraints, high patient acuity, and limited staffing, making it challenging to allocate at least 3 minutes for handwashing.

Most of the studies assessed the efficacy of handwashing duration by culturing the hands. No studies, as per our research evaluated the direct clinical implication comparing different handwashing times. A shorter handwashing time of 90 seconds may offer a more realistic and sustainable solution for ED healthcare workers while maintaining the integrity of infection control practices. This study aims to investigate whether a 90-second surgical handwashing time is non-inferior to the conventional 2 to 5 minutes in preventing CLABSI in the ED setting and see if this shortened duration improves compliance among physicians.

By exploring the efficacy of a shorter handwashing time, this study seeks to contribute to the development of more efficient, practical, and evidence-based infection control guidelines for ED healthcare workers.