immunology (effects of handwashing).
Description
I have attached a word document that contains
2 tables, to be used in the result
introduction & methods.(please paraphrase the intro and methods, as they are previous year’s student’s work + method might be slightly different like timing so please change them)
Please write conclusion along the line
1.soap or water only washing are both effective
2.based on previous studies, soap washing is more effectvive than water alone, but based on our data, it suggest differently
3. time spent on washing have no releavne in reduction of bacteria with or without soap
4.hand sanitsation with the use of soap and proper hand drying should be done before and after and between each patient to reduce unnecessary health risk.
lastly i have attached a reference for the use) and the marking guide.
Epidemiol. Infect. (1997), 119, 319?325. Printed in the United Kingdom # 1997 Cambridge University Press
Residual moisture determines the level of touch-contact- associated bacterial transfer following hand washing
D. R. PATRICK, G. FINDON ??? T.E.MILLER*
Department of Medicine, University of Auckland, Auckland, New Zealand
(Accepted 5 August 1997)
SUMMARY
We report here a new and critical determinant of the e?ectiveness of hand hygiene procedures, namely the amount of residual moisture left on the hands after washing and drying. When samples of skin, food and utilities were touched with wet, undried hands, microbial numbers in the order of 68000, 31000 and 1900 respectively translocated to these representative surfaces. Bacterial numbers translocating on touch contact decreased progressively as drying with an air or cloth towel system removed residual moisture from the hands. A 10 s cloth towel?20 s air towel protocol reduced the bacterial numbers translocating to skin, food and utilities on touch contact to 140, 655 and 28 respectively and achieved a 99?8, 94 and 99% reduction in the level of bacterial translocation associated with wet hands. Careful hand drying is a critical factor determining the level of touch-contact-associated bacterial transfer after hand washing and its recognition could make a signi?cant contribution towards improving handcare practices in clinical and public health sectors.
INTRODUCTION
An awareness that an individual?s hands can be a source of cross infection and a vehicle for the transmission of infectious disease has remained un- disputed since Semmelweiss in Europe [1]and Wendall Holmes in the United States [2] clearly demonstrated the e?cacy of hand washing in the prevention of puerperal sepsis and its associated mortality. There is no shortage of scienti?c papers in the medical, nursing and surgical literature on the subject of hand hygiene and infection control but the emphasis has been on the e?ect of hand disinfection and washing on the indigenous or experimentally introduced skin mi- crobial ?ora. As a result, hand hygiene has become synonymous with practices and products that reduce microbial numbers on the hands. In the course of studying hand hygiene practices in relation to touch contamination induced peritonitis in
* Author for correspondence: Dr Thomas Miller, Department of Medicine, Auckland Hospital, Private Bag 92-024, Auckland, New Zealand.
patients undergoing peritoneal dialysis, we made the serendipitous discovery that the single most important determinant of the number of micro-organisms trans- locating from an individual?s ?ngers to the dialysis bag exchange equipment was the residual moisture remaining on the hands after washing [3]. When a patient?s hands were carefully dried, bacterial con- tamination of the plastic connecting devices was very low. Damp hands however facilitated the transfer of many thousands of micro-organisms to the connecting devices and ultimately, into the peritoneal cavity. These observations established a clear association between residual moisture on the hands and bacterial translocation with touch contact but the relationship was not determined in quantitative terms. In the current investigation we set out to quantify the e?ect of hand drying on touch-contact-associated translocation of micro-organisms from ?ngers to surfaces representing skin, food and clinical utilities. With this information available, we were able to devise a practical hand drying procedure that reduced touch contact contamination to a minimum. The
320 D. R. Patrick, G. Findon and T. E. Miller
principles we established have considerable impli- cations for infection control procedures in clinical practice, public health and nursing hygiene and, indeed, in any situation where it is important to limit touch-contact-associated dissemination of infectious agents.
MATERIALS AND METHODS
Subjects
Male and female volunteers from the administrative and technical sta? of the Department of Medicine at Auckland Hospital participated in the bacterial translocation studies. Public rest rooms were moni- tored for studiesinvolving ?use?handdrying practices.
Tap water microbiological quality
The tap water used for hand washing in all these experiments met Ministry of Health drinking water standards and, according to company records and our own regular analyses, it contained no demonstrable coliforms or other aerobic micro-organisms over the period of the study.
Hand drying methods
Reusable single serve cloth towels of the pull down roller type were supplied by New Zealand Towel Services (NZTS). Sections for drying were dispensed when pulled down by user. The towels were freshly laundered and autoclaved at 121 ?C for 30 min before use. An automatic air towel, model Mk 9, supplied by NZTS was ?tted with a timer which was designed to provide a 45 s uninterrupted ?ow of hot air.
Representative surfaces used in bacterial transfer analysis
Chamois cloth, representing skin, was cut into 2 cm squares and sterilized by autoclaving at 121 ?C for 15 min. Food was represented by 2 cm squares of licorice straps which were sterilized by ethylene oxide gas. Plastic pipette tips (1 ml), cut in half laterally and sterilized by autoclaving, were representative of utility surfaces.
Quantitative bacteriology
After handling, the representative surface (chamois, licorice or plastic pipette tip) was placed into 9 ml of saline solution and vortexed for 15 s to remove
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0 10 20 30 40 50 Drying time (s)
Water remaining (%)
Fig. 1. Removal of residual water, after washing, by cloth (E) and air (_) towel hand drying systems. Error bars represent the ?.?.?., n?5 for each time point.
adherent bacteria. A 1 ml aliquot was incorporated in a Columbia agar pour plate and incubated at 37 ?C for 24 h, after which bacterial numbers were enu- merated. Control plates, to check for sterility, were used for each experimental procedure but without the touch contact.
Experimental protocols
Analysis of the drying e?cacy of cloth and air towels
The subjects? hands were wet under running tap water for 5 s, ?icked twice, and then dried for either 0, 2, 4, 6, 8, 10, 15 or 45 s for cloth and 0, 5, 10, 20, 30 or 45 s for the air towel. The amount of water left on the hands after each drying period was quanti?ed by ?nishing the drying using a pre-weighed paper towel. This was then reweighed to determine the amount of water remaining on the hands and subsequently transferred to the pre-weighed paper towel, after the above drying times. Each point presented in the results is the mean of ?ve samples.
Selection of hand drying times for cloth and air towel bacterial translocation experiments
Hand drying times used in the various experiments were based on the data from the above experiment and summarized in Figure 1. This shows that the drying e?ciency of the cloth and air towel systems di?ered substantially. Bacterial translocation studies using the cloth towel were therefore carried out using drying times of 0, 2, 8, 15 and 45 s after hand washing. In the case of the air towel the hand drying intervals used were 0, 10, 20 and 45 s.
Bacterialtransfer321
Bacterial numbers transferring to representative surfaces after hand drying
Pretest sampling of hands was carried out, before any contact with water, by ?ngering a representative surface for 5 s using the ?ngers of both hands. The hands were then held under running water for 5 s and ?icked twice to remove excess water, before ?ngering another piece of the representative surface (100% wet) for a further 5 s. The numbers of micro- organisms transferring to the surfaces were then quanti?ed as described above. After an interval of 10 min normal activity, the hands were wet again. They were then dried, using one of the towel systems, for a period determined by the individual protocol and another portion of the surface under test was handled. Bacterial numbers transferred to each sur- face were estimated for the two towel types after drying for 0, 2, 8, 15 and 45 s for cloth towel and 0, 10, 20 and 45 s for the air towel. When using the air towel, emphasis was placed on drying the ?nger tips which were held vertically under the air ?ow. Seven volunteers were sampled six times for each type of material and each drying time.
Combination cloth towel and air towel
A dual drying protocol was developed to increase the e?ciency of the previous drying procedures. Pretest and 100% wet samples were taken as above and after 10 min, the hands were wet again. The hands were then dried with a clean towel for 10 s and immediately placed under an air towel for a further 10 or 20 s, depending on the protocol. Bacterial transfer to chamois cloth (?skin?), food and utilities was then estimated as above. Six volunteers were sampled six times for each protocol.
Rest room observations
Male and female public rest rooms were monitored to ascertain the length of time that individuals dried their hands using cloth or air towels. A stop watch was used to time hand drying.
RESULTS
Comparative hand drying e?ciency of air and cloth towels
Subjects? hands were wet under running tap water and dried for various times using either the air or cloth
towel systems. The residual moisture on the hands was quanti?ed by further drying on pre-weighed paper towels. Reweighing of these towels allowed the amount of water remaining on the hands after speci?c drying times to be determined. Residual water was e?ectively and e?ciently removed from the hands by the cloth towel system. After 10 s drying with a cloth towel, 4% of the residual water remained on the hands and with 15 s drying this ?gure was reduced to 1%. The air towel took longer to achieve a similar endpoint and needed a drying time of 45 s to reduce residual water on the hands to 3% (Fig. 1).
E?ect of hand drying using cloth and air towels, on microbial transfer following touch contact with ?skin?, food and utilities
Cloth towel
When ?skin? was touch contaminated with dry ?ngers pretest, 200 micro-organisms translocated from the ?ngers to skin. Touch contact with wet hands led to an average of 60400 micro-organisms translocating. The number translocating on touch contact pro- gressively declined as the time spent on hand drying increased. For example, after 8 s of drying 24200 micro-organisms translocated when ?skin? was touched (40% of the number transferred by wet, but undried hands, which were taken as 100%). After 15 s drying 6700 (11%) micro-organisms translocated and after 45 s 850 (1%) were transferred by touch contact. In the case of hand contact with food, a mean of 39300 micro-organisms translocated when licorice was handled with wet hands (drying time 0). Cloth drying of the hands had an immediate e?ect on microbial transfer. A drying interval as brief as 2 s reduced transferable numbers from 39300 to 7500. Further reductions in the number of micro-organisms transferred by touch contact were observed as more time was spent on hand drying and, after 8 and 45 s drying time, 3000 and 830 micro-organisms trans- located respectively (8 and 2% of the potential transferrable number). Bacterial numbers trans- locating to the ?utility? representative surface were noticeably lower than the two previous surfaces (1800 translocating with wet hands). Hand drying with the cloth towel e?ectively reduced bacterial numbers translocating to this surface. After 2 s drying, 18% of the potentially transferable microbial ?ora had trans- located but by 15 s this ?gure had fallen to 3% representing just 60 micro-organisms (Table 1, cloth towel).
322 D. R. Patrick, G. Findon and T. E. Miller
Table 1. E?ect of hand drying with cloth or air towels on microbial transfer to representative surfaces following touch contact
Cloth towel
Drying time (s) after hand wetting? 0 2 8 15 45 Pretest
Skin 60400* 27400 24200 6700 850 200 ? ? ? ? ? ? 7900? 5300 6100 950 130 50 (100%)? (45%) (40%) (11%) (1%) (0?3%) Food 39300 7500 3000 2800 830 490 ? ? ? ? ? ? 5400 2300 400 660 170 70 (100%) (19%) (8%) (7%) (2%) (1%) Utilities 1800 320 160 60 40 15 ? ? ? ? ? ? 200 60 30 10 7 5 (100%) (18%) (9%) (3%) (2%) (0?8%)
Air towel
Drying time (s) after hand wetting? 0 10 20 45 Pretest
Skin 72300 28000 19000 3700 250 ? ? ? ? ? 16400 5000 4200 1000 40 (100%) (39%) (26%) (5%) (0?3%) Food 41700 26400 9700 690 500 ? ? ? ? ? 6300 3300 1800 80 100 (100%) (63%) (23%) (2%) (1%) Utilities 1600 1400 360 100 14 ? ? ? ? ? 180 180 100 50 4 (100%) (88%) (23%) (6%) (0?9%)
* n?42 for each time point and representative surface. ? ? represents the standard error of the mean. ? Percent bacteria translocating after the speci?ed drying time compared to the number translocating with wet, undried hands (time 0).
Air towel
Air towel hand drying took signi?cantly longer than cloth towel use to a?ect microbial translocation levels. In the case of ?skin?, bacterial translocation numbers were reduced to 26% after 20 s drying and 5% after 45 s drying (3700 translocating compared with 72300 with wet undried hands). Bacterial transfer levels to food were reduced with air towel drying but the subjects? hands needed protracted exposure. After 10 and 20 s drying, numbers translocating were 26400 and 9700 respectively representing 63 and 23% of the potentially transferable load (41700 at drying time 0). Drying for 45 s reduced transferable numbers to 690 (2% of potential). Air towel drying had a minimal e?ect on the bacterial transfer to utilities after 10 s
drying (a mean of 1400 translocating vs. 1600 for wet hands), but by 20 s, bacterial numbers had decreased to 360 (23%). After 45 s air drying, the equivalent ?gures were 100 micro-organisms representing 6% of the number transferred at drying time 0 (Table 1, air towel).
E?ect of a dual cloth and air towel hand drying protocol on bacterial translocation
The experiment involved hand washing followed by the use of a cloth towel for 10 s and an air towel for either 10 or 20 s ? the so-called 10}10 or 10}20 protocols. Bacterial numbers in the order of 71500 which translocated to skin when the hands were wet
Bacterialtransfer323
Table 2. E?ect of a combined cloth and air towel hand drying protocol on bacterial translocation to representative surfaces
Dual protocol
Drying time (s) 0 10}10* 10}20? Pretest
Skin 71500??4900? 300?50 140?20 50?10 (100%)? (0?4%) (0?2%) (0?1%) Food 11700?5300 1600?300 655?120 420?50 (100%) (14%) (6%) (4%) Utilities 2400?400 90?20 30?10 30?5 (100%) (4%) (1%) (1%)
* Hand drying protocol using the cloth towel for 10 s followed by 10 s under the air towel. ? Similar procedure to above but using the air towel for 20 s. ? n?36. ? Standard error of the mean. ? Percentage of bacteria translocating compared to the number translocating with wet, undried hands (time 0).
Table 3. Observations of hand drying practices in rest room areas
Male Female
Drying method
Subject numbers
Drying time (s)
Subject numbers
Drying time (s)
Air towel 100}74* 17?0?10?3? 100}70 13?3?6?4 Cloth towel 100}77 3?5?2?3 100}97 5?2?2?7
* Total number of subjects observed wetting hands}total number of subjects wetting and drying hands. ? ?1 ?.?.
were reduced to 300 when the 10}10 procedure was used. Extending the drying time with the air towel to 20 s (10}20) reduced the translocation process still further. Substantial reductions in bacterial trans- location to food and utilities were also achieved with the 10}10 or 10}20 protocols (Table 2).
Hand drying practices under ?use? conditions
Observations were carried out in male and female rest rooms to ascertain the time individuals spent drying their hands using single serve cloth and air towels. Rest rooms used for the observations had either single serve cloth towel or hot air towels installed but not both. Male users spent an average of 3?5 s on cloth towel hand drying and 17 s under the air towel. The comparable ?gures for women were 5?2 and 13?3s (Table 3).
Data obtained from Table 1 were used to construct curves (a) and (b), Figure 2, which de?ned the relationship between increments in hand drying times and a reduction in bacterial translocation. Hand drying times of male and female users of air towel (a) and cloth (b) systems (Table 3) were then related to these curves and the percentage reduction in bacterial translocation was estimated by reference to the vertical axis. Thus hand drying intervals of 15 s found in this study for female and male users of the air towel system (c) and (d) on curve (a) reduced bacterial translocation to skin to approximately 33% of the translocation level associated with wet hand touch contact. Using data from Table 1, this would equate to 21900 micro-organisms as compared with 66300 (100%). The average ?gure of 3?5 s of cloth towel drying for male and female users (positions (e) and (f) on curve (b)) achieved a slightly less favourable translocation ?gure of 40% (26500 micro-organisms).
324 D. R. Patrick, G. Findon and T. E. Miller
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Bacterial translocation to skin (%)
(c)(f) (e) (d)
(a)
(b)
(100%=66300 micro-organisms) (g)
Fig. 2. Reduction in bacterial translocation achieved by cloth or air towel use in public rest rooms. (a), (b). Curves describing the relationship between bacterial translocation to skin, and hand drying time (data for cloth (??, curve (b)) and air (???, curve (a)) towels derived from Table 1). (c), (d). Air towel drying times used by male and female rest room patrons (data derived from Table 3). (e), (f). Cloth towel hand drying times for male and female rest room patrons (data derived from Table 3). (g) 66300 is the mean of the wet-hand bacterial translocation counts for cloth and air towel studies using ?skin? as the touch contact surface; n?84 (see Table 1).
DISCUSSION
The contribution of poor hand hygiene to the spread of infectious diseases has been recognized for centuries and early civilizations incorporated hand washing procedures into rites and laws to ensure basic standards were met. Much of the research of the last 30 years on hand hygiene has focused on attempts to remove transient contaminants. Typically these proto- cols involved seeding a test subject?s hands with a microbial contaminant and determining the e?ect of hand care agents and procedures on their numbers. While these procedures provided a valid answer to the questions being asked, they assessed a limited aspect of hand hygiene practice. A chance observation that the touch contamination level of peritoneal dialysis connector equipment increased after patients had washed their hands led us to the suggestion that a ?lm of moisture left on the hands after washing acted as a conduit enhancing the transfer of skin micro?ora when touch contact was made. This led to the development of a test system capable of quantifying what we consider to be one of the principal objectives
of hand hygiene procedures i.e. a reduction of the number of micro-organisms transferred by touch contamination. In the current experiments, the drying e?ciency of cloth and air towels was ?rst compared. After 10 s drying, single serve cloth towels removed 96% of the water from a subject?s hands, whereas air towel drying needed 45 s drying time to achieve the same endpoint. The experiments which followed were of considerable relevance to infection control measures in that they established hand drying as an essential component of hand hygiene procedures. When material representing skin, food and utilities was touched with wet hands, astonishingly high numbers of micro-organisms trans- located from the subjects? ?ngers to the test material. Microbial numbers in the order of 68000, 31000 and 1900 were found on samples of skin, food and utilities respectively after touch contact. Equally surprising was the reduction in bacterial translocation achieved using a simple 10}20 post-wash hand drying pro- cedure. A 10 s cloth towel?20 s air towel dry after washing reduced the translocation numbers to skin, food and utilities to 140, 655 and 30 respectively and achieved a 99?8, 94 and 99% reduction in bacterial translocation ?gures associated with wet hands. These results provide irrefutable support for our hypothesis that residual moisture left on the hands after washing provides an interface that allows the translocation of micro-organisms from ?ngers to solid surfaces during touch contact. Hand drying after washing is therefore a critical factor in determining the level of touch- contact-associated cross contamination, although its relevance to hand hygiene seems to have been overlooked. Indeed an extensive search of the litera- ture has revealed only two studies which have recognized the relevance of the surface moisture to bacterial cross contamination [4, 5]. Questions have arisen as to why no soap or skin disinfectants were used in these studies. As our aim was to determine the relationship between residual moisture on the hands and bacterial translocation levels, the use of hand cleaning and disinfecting agents would have com- plicated the interpretation of the results. The e?ect of such agents on bacterial translocation levels is clearly relevant to hand hygiene and is a topic we will be pursuing. Microbial translocation numbers following touch contact with wet hands and hands that have been carefully dried with appropriate equipment, represent the two extremes encountered in hand hygiene practice. We were able to show that the level of
Bacterialtransfer325
bacterial translocation following touch contact is related to the time spent on hand drying, i.e. bacterial numbers translocating progressively decrease, as moisture is removed with more conscientious drying (Table 1). The relationship between the theoretical extremes and hand drying, under use conditions, was examined by timing hand drying practices of male and female rest room patrons. This information was used to assess the e?ect of their hand drying practices on bacterial translocation following the use of restroom facilities. The results (Fig. 2) showed that, while users of cloth and air towel hand drying equipment were able to achieve a useful reduction in bacterial translocation (25000 micro-organisms translocating compared with a potential of 60?70000 with skin touch contact) the outcome fell well short of that achievable using an optimized protocol. Protocols such as the 10}20 procedure, which utilize both cloth and air towels, reduce translocatable bacteria to a few hundred micro-organisms and have clear implications for clinical areas where infection control is a high priority. Other areas likely to bene?t from observing the principal ?ndings of the study could be the food industry, home nursing situations and child care facilities where the spread of infection from person to person is a common event. The results in no way detract from the importance of adequate washing in reducing the transient contaminant numbers on the hands. Rather, they complement this basic aspect of hand hygiene by ensuring that touch-contact-asso-
ciated cross contamination is reduced to a minimum. The introduction of this concept into hand hygiene practices will undoubtedly lead to improved hand care in a number of clinical and public health settings.
ACKNOWLEDGEMENTS
The authors wish to acknowledge the interest of NZTS in this research and their generous assistance through ?nancial support and the supply of material and equipment.
REFERENCES
1. Semmelweiss I. The etiology, the concept, and the prophylaxis of childbed fever. In: Pest CA, ed. (Murphy FP, translator). Hartleben?s Verlag ? Expeditious. Birmingham: Classics of Medicine Library, 1861, republished 1981. 2. Holmes OW. The contagiousness of puerperal fever. N Engl Quarterly J Med Surg 1842?43; 1: 503?30. 3. Miller TE, Findon G. Touch contamination of con- nection devices in peritoneal dialysis ? a quantitative microbiologic analysis. Periton Dial Internat (In Press). 4. Marples RR, Towers AG. A laboratory model for the investigation of contact transfer of micro-organisms. J Hyg 1979; 82: 237?48. 5. Macintosh CA, Ho?man PN. An extended model for the transfer of micro-organisms via the hands: di?er- ences between organisms and the e?ect of alcohol disinfection. J Hyg 1984; 92: 345?55.
Group: Time spent washing (seconds) Pre-wash
(# colonies) Post-wash
(# colonies) Difference
Group 1: 5
11.5 18.75 7.25 increased
Rods and Cocci Cocci only
Group 2: 10 27.5 25.5 2 reduced
Group 3: 300 29 38 9 increased
Table 1. Hand washing without soap
Group: Time spent washing (seconds) Pre-wash (# colonies) Post-wash
(# colonies) Difference
Group 4: 1 6 1 5 reduced
Group 5: 5 38.6667 15.6667 23 reduced
Group 6: 10 26.556 18.222 14.334 reduced
Group 7: 15 10 6.33 3.67 reduced
Group 8: 20 12 5.75 6.25 reduced
Table.2 Hand washing with soap
Introduction
Chiropractic care is a non-invasive, hands-on healthcare discipline that mainly focuses on the musculoskeletal system. Since numerous infectious disease can be easily spread via physical contact, the manual approach of chiropractic care can pose unnecessary health risks to patients especially in the immune suppressed. Of concern is the transmission of methicillin-resistant staphylococcus aureus (MRSA) as it is very difficult to treat since it has high levels of morbidity (Green et al., 2012). Patient safety should always be the foundation of healthcare practice so practitioners should take extra precautions to control bacterial transmission (Davis et.al, 2006) Hence, to raise awareness on the importance of sanitization and to minimize the risk of spreading infectious bacterial diseases via physical contact, this study was done to evaluate the effectiveness of handwashing at different scenarios in order to rule out the best possible way of washing the hands to lessen the spread of infection via hand contact. The aim of this study is to investigate whether washing hands with soap or water alone is more effective and if time spent washing has an effect on reducing bacteria.
Methods
The participants of the study involved 2nd year chiropractic students in a lab setting where students were divided into 6 groups. Group 1 to 3 used no soap and washed their hands for 0, 5,10seconds respectively. Groups 4 to 6 used soap and washed their hands for 5, 10,15seconds respectively. Students were given 2 plates of sterile agar and were asked to touch one of them with their fingers before the hand wash and labelled it as pre-wash. The other plate was to be touched after the hand washing and hands dried with a paper towel. The plate is then labelled as post-wash. Lids were placed on the agar plates and left to incubate at 27?C for 48hours then 2? for 12days.
After the incubation period, the agar plates were uncovered and gram stained slides were prepared by the students. To prepare the gram stained slides, a heat-fixed smear of bacteria was prepared. A clean slide was taken and flamed to get rid of any alcohol. The slide was left to cool and labelled. Next, using a sterile loop, a small amount of bacterial colony from the agar plate was taken and placed on the slide. A drop of sterile saline was used to emulsify it and the liquid was spread over an area of about 1cm square. The smear was then air dried. To heat fix the dried slide, forceps was used to hold the slide and passed 3 times through the hot part of the Bunsen flame with smear side up. The slide is left to cool and stained with a few drops of crystal violet for 60seconds. Excess crystal violet was poured off and rinsed with a gentle stream of running tap water. The smear is then covered with iodine and left for 45seconds. Next, excess iodine was poured off and the slide was washed front and back with acetone solution and then immediately washed under a gentle stream of running tap for 5-10seconds. Safranin is used to counterstain for 30seconds. Excess stained is washed off and the slide gently blotted dry. Lastly, the slide is viewed under a compound microscope.
The gram stain, morphology and amount of the bacteria present was recorded. All of the apparatus including the gram stains were provided by the School of Life Sciences at Murdoch University. The sterile agar plates were prepared by the university?s lab technician. There was also no need for ethical application in this experiment.
PLEASE Paraphrase them all, except for the table.
I have attached a word document that contains
2 tables, to be used in the result
Introduction & methods.(please paraphrase the intro and methods, as they are previous year’s student’s work + method might be slightly different like timing so please change them)
Please write conclusion along the line
1. Soap or water only washing are both effective
2. based on previous studies, soap washing is more effective than water alone, but based on our data, it suggest differently
3. Time spent on washing have no relevance in reduction of bacteria with or without soap
4. Hand sanitsation with the use of soap and proper hand drying should be done before and after and between each patient to reduce unnecessary health risk.
Lastly I have attached a reference for the use) and the marking guide.
word limit = 1500
Hand washing Lab Report Marking Guide
Name: Needs Work Well Done
Introduction / 4
Introduction presented in logical manner from broad to specific
Used appropriate peer reviewed references
Clear statement of relevance of experiment to chiropractic profession
Stated the question to be answered
Methods / 2
Explanation of how the data was collected, noting why this was
appropriate for the study
Outline of how the data will be analysed and why
Results / 2
Results reported objectively
Logical flow to results section
Discussion /5
Grammar and spelling are at a professional level
Discussion adequately explores results in light of previous studies
Referencing / 3
In-text referencing done correctly in APA style
Minimum of 5 references used
References used listed in the correct APA style
Overall Presentation / 4
Fluency of writing in a clear and logical manner
Sentence and paragraph structure, grammar and spelling
Clear, neat, consistent format of document, headings, text and references, appropriate word length.
Marker comment:
Mark: /20
Marking guide modified from original generously donated
immunology (effects of handwashing)
