Information about Hand Hygiene
The Rationale for Hand Hygiene
Why is hand hygiene important?
Hand hygiene refers to removing or killing microorganisms (germs)
on the hands. When performed correctly, hand hygiene is
the single most effective way to prevent the spread of communicable
diseases and infections. In health care, hand hygiene is used to
eliminate transient microorganisms that have been picked up via
contact with patients, contaminated equipment or the environment.
Hand hygiene may be performed either by using soap and running
water, or with alcohol-based hand rubs.
When should hand hygiene be performed?
In health care, hand hygiene is required:
- Before and after contact with any patient/resident, their body substances
or items contaminated by them
- Between different procedures on the same patient/resident
- Before and after performing
invasive procedures
- Before preparing, handling, serving or eating food or feeding a patient/resident
- After assisting patients/residents with personal care (e.g. assisting patient to blow nose, toileting or doing wound care)
- Before putting on and after taking off gloves
- After performing personal functions (e.g. using the toilet, blowing
your nose)
- When hands come into contact with secretions, excretions, blood and
body fluids (use soap and running water whenever hands are visibly
soiled)
When should soap and water be used?
The mechanical action of washing, rinsing and drying removes
transient bacteria present on the hands. Hand washing with soap
and running water must be performed whenever hands are visibly
soiled.
Any type of plain soap may be used. However, bar soaps are not
acceptable in health care settings except for single patient/resident
personal use. If used, bar soap should be kept in a self draining
holder that is cleaned thoroughly before new bars are put out.
Liquid soap containers should be used until empty and then discarded.
Soap containers must not be topped up, as there is a risk of contamination
of residual soap. Antibacterial soaps may be used in critical care
areas such as ICU, or in other areas where invasive procedures
are performed.
When should alcohol-based hand rubs be used?
Alcohol-based hand rubs/gels/rinses are the preferred method for decontaminating
hands, provided they contain more than 60% alcohol. They are
widely used in health care settings, or in situations where running
water is not available. Using alcohol-based hand rub is better
than washing hands (even with an antibacterial soap) when hands
are not visibly soiled.
Won't frequent hand hygiene dry my skin?
Intact skin is the first line of defence against microorganisms,
hence it is important to maintain good skin care. To prevent chafing,
wet your hands before applying soap and use a mild lotion soap
with warm water; pat rather than rub hands dry; and apply lotion
liberally and frequently. Skin lotions should be chosen that will not interfere with
glove integrity.
Most alcohol-based hand rubs contain emollients to reduce
the incidence of skin irritation. Frequen use of alcohol-based hand
rub actually lessens the incidence of skin breakdown, as it does
not subject hands to the friction and abrasion involved in hand
washing and drying hands.
If an individual develops compromised skin integrity,
he/she should be referred to Occupational Health for assessment.
Hand Hygiene Procedures
How do I use soap and water?
Good hand hygiene
technique is easy to learn. Follow these
five simple steps to keeping hands clean:
- Remove hand and arm jewellery and wet your hands with warm
(not hot) running water.
- Add soap, and then rub your hands together, making a soapy
lather. Do this for at least 15 seconds,
being careful not to wash the lather away. Wash the front and
back of your hands, as well as between your fingers and under
your nails.
- Rinse your hands well under warm running water, using a rubbing
motion.
- Wipe and dry hands gently with paper towel. Rubbing vigorously
with paper towels can damage the skin.
- Turn off tap using paper towel so that you do not recontaminate
your hands.
- Download CHICA-Canada's Hand Washing brochure:
How do I use alcohol-based hand rubs?
Alcohol-based hand rubs should only be used if no visible dirt
is present on the hands.
- Remove hand and arm jewellery.
- Apply enough antiseptic to make about the size of a quarter onto
your hands, enough when you rub your hands together to cover
all areas of your hands, including under your nails (1-2 pumps).
- Use a rubbing
motion to evenly distribute the antiseptic product over all surfaces
of the hands, particularly between fingers, fingertips, back
of hands and base of thumbs.
- Rub hands until your hands feel dry (minimum 15-30 seconds).
What are some mistakes I should avoid regarding hand hygiene?
- DON'T leave hand jewellery on when performing hand hygiene.
Jewellery is very hard to clean and hides bacteria and viruses
from the mechanical action of the washing/rubbing.
- DON'T use artificial nails, nail enhancements or long (>3-4mm)
nails, as they trap bacteria and are difficult to keep clean.
- DON'T wear chipped nail polish, as bacteria may become trapped
along the edges
- DON'T use a single damp cloth to wash a group of patient's/resident's/children's
hands.
- DON'T use a standing basin of water to rinse hands.
- DON'T use a common hand towel.
- DON'T use sponges or non-disposable cleaning cloths. Remember
that germs thrive on moist surfaces.
HAND HYGIENE LINKS
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In order to help victims of the Yushu April 14th earthquake, Sichuan University for Nationalities, Kangding, China has translated and adapted the CHICA-Canada handwashing brochure, with the permission of CHICA-Canada. The information in the CHICA-Canada brochure is very helpful in Yushu now where basic hygiene is a major issue. A Tibetan edition and Chinese edition of the brochure are at: http://www.grandala.org/clean%20and%20safe.html.
- Below picture ten says: Don't use the same cloth towel you use for your hands on your face.
- Below picture twelve says: Let cloth towels hang in the sun.
- Below picture thirteen are student translations for the message: Is the person beside you washing their hands?
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| STANDARDS AND GUIDELINES |
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| EDUCATION AND TEACHING AIDS |
Free Information:
- "STOP! Clean your hands" Canada's Hand Hygiene campaign developed in conjunction with CHICA-Canada, the Canadian Council on Health Services Accreditation, the Canadian Patient Safety Institute and the Public Health Agency of Canada:
- "Just
Clean Your Hands" A hand
hygiene improvement program developed by the
Ministry of Health and Long-Term Care in Ontario, based
on the WHO model:
- Hand Hygiene Techniques - posters and brochures that show
proper hand hygiene technique through pictures:
- "Clean
Hands: It's What We Do" Interactive hand hygiene program developed
by the Calgary Health Region. Interactive modules:
- "PICNet's Hand Hygiene Resource Page Resources from the Provincial Infection Control Network of British Columbia (PICNet) include:
- "SAVE LIVES: Clean Your Hands" The World Health Organization's hand hygiene program undertaken as part of the First Patient Safety Global Challenge, Clean Care is Safer Care
- "Operation
Clean Hands" A campaign from
the American Society for Microbiology aimed at spreading
the message about the importance of handwashing. Some
downloadable materials include:
- Hand
Hygiene Resource Center A project of the St.
Raphael Healthcare System dedicated to improving hand
hygiene practices in healthcare settings. A number of
educational tools are available for downloading:
- "Hopisafe.ch " A
project of Hôpitaux Universitaires
de Genève, focusing on hand hygiene and other incentives to prevent
hospital-acquired infections:
- "Infection:
Don't Pass It On" Campaign A
project of the U.S. Department of Veterans Affairs, with
the messages "Wash
your hands" and "Cover your coughs". Many educational materials available,
including:
- "Germs.
Wash your hands of them". Scotland's National Hand Hygiene Campaign
has useful information, posters and other resources available:
- Centers for Disease Control and Prevention (CDC)
- Public Health
- Hand Hygiene
after a Disaster (CDC) Flyers, stickers, handout
cards and slide sets are available for use when handwashing facilities
have been interrupted:
- Soap and Detergent Organization
Information for Purchase:
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| HAND HYGIENE VIDEOS |
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| PUBLICATIONS,
RESEARCH AND REFERENCES |
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| OTHER
INFORMATION |
| Information
for Children & Teachers
History of Hand Hygiene
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