Hand Hygiene is very important as it reduces the spread of micro-organisms in healthcare settings. According the World Health Organization (WHO) health care associated infections (HCAI) affects millions of patients every year. It is the most common adverse event in the health care setting and it can be prevented by good hand hygiene.
1) Hand washing helps to remove micro-organisms that might cause disease.
2) Washing with soap and water kills many transient micro-organisms and allows them to be mechanically removed by rinsing.
3) Washing with antimicrobial products kills or inhibits the growth of micro-organisms in deep layers of the skin.
4) Using alcohol based products for hand hygiene also achieves similar results.
Hand washing is important:
- Before patient contact
- Before aseptic tasks
- After exposure body fluid
- After contact with a patient's surroundings
- On arrival at work
- Between contact with different patients
- Between tasks and procedures on the same patient to prevent cross-contamination
- Immediately after removing gloves
- Before leaving work
- After using the restroom
Rationale for good hand washing and hygiene
1) Clean your hands before touching a patient to protect the patient against harmful germs carried on your hands.
2) Clean your hands immediately before any aseptic task to protect the patient against harmful germs, including the patient's own germs, entering his or her body.
3) Clean your hands immediately after exposure to body fluids (and after glove removal) to protect yourself and the healthcare environment from harmful patient germs.
4) Clean your hands after touching a patient and his or her immediate surroundings to protect yourself and the healthcare environment from harmful patient germs.
5) Clean your hands after touching any object or furniture in the patient's immediate surroundings, when leaving (even without touching the patient) to protect yourself and the healthcare environment from harmful patient germs.
Hand hygiene techniques
Hand washing of hands and wrists; the hands are washed for a minimum of 10-15 seconds with soap (plain or antimicrobial) and water.
Hand antisepsis removes or destroys transient micro-organisms and enables a prolonged effect. It may be carried out by washing hands and forearms with antimicrobial soap and water for 15-30 seconds (following manufacturer's instructions). Also by sanitizing hands with a waterless, alcohol-based liquid or gel for 15-30 seconds (this method is appropriate for hands that are not visibly soiled).
Surgical hand antisepsis removes or destroys transient micro-organisms and enables a prolonged effect. The hands and forearms are washed thoroughly with an antiseptic soap for a minimum of 2-3 minutes. The hands are dried using a sterile towel. Surgical hand antisepsis is required before performing invasive procedures
Recommended materials for hand hygiene
Running water from elbow-faucets, soap (plain or antimicrobial soap). Also to note that in many centers, bar soaps are no longer practiced as it encourages the growth of some micro-organisms such as pseudomonas. Clean liquid soap dispensers are also needed and should be cleaned thoroughly when empty and before refilling. Specific antiseptics recommended for hand antisepsis include 2-4% chlorhexidine, 70-90% alcoholic hand sanitizers. Waterless antiseptic agents needed (60-90% alcohol-based) include alcohol gel and alcohol liquid.
How to perform good hand hygiene
1) Prepare for hand washing.
2) Remove jewelry (rings, bracelets, watches) before washing hands.
3) Ensure that the nails are clipped short (do not wear artificial nails).
4) Roll the sleeves up to the elbow.
1) Wet the hands and wrists, keeping hands and wrists lower than the elbows (allows the water to flow to the fingertips, avoiding arm contamination).
2) Apply soap (plain or antimicrobial) and lather thoroughly.
3) Use firm, circular motions to wash the hands and arms up to the wrists, covering all areas including palms, back of the hands, fingers, between fingers and lateral side of fifth finger, knuckles and wrists. Rub for minimum of 10-15 seconds.
4) Repeat the process if the hands are soiled.
5) Clean under the fingernails.
6) Rinse hands thoroughly, keeping the hands lower than the forearms.
7) Dry hands thoroughly with disposable paper towels or napkins.
8) Use a paper towel or elbow to turn off the faucet to prevent recontamination.
9) Discard the towel if used, in an appropriate container without touching the bin lids with hand.
Proper hand hygiene will help reduce spread of microorganisms in the workplace. A hand hygiene awareness program should be established for all staff in healthcare settings. Clean hands and prevent millions of health care associated infections (HCAI).
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