By Travaughn Baker-Johnson, CIC
Director of Infection Control
Emergency Hospital Systems
Practicing good hand hygiene is a simple and effective way to prevent and slow the spread of infections. Cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics and are becoming increasingly difficult to treat.
There are two methods for Hand Hygiene: alcohol-based hand sanitizer and washing with soap and water. Alcohol-based hand sanitizers are the most effective and preferred products for reducing the number of germs and cleaning of hands for healthcare providers in most clinical situations.
Even in healthy the skin is colonized with microorganisms. The bacteria that make up normal flora vary from person to person and even within the same person these bacteria vary from body system to body system.
The normal flora of the gut is different than the normal flora found on the skin. Normal Flora can be placed into two categories: Transient and Resident. Transient bacteria are found on the outer layers of skin and are easily removed by hand washing and are organisms most likely to result in hospital acquired infections (HAI’s).
Resident flora is more deeply attached to the skin & are harder to remove, and when disturbed through hand washing or antibiotic usage, are quick to reestablish themselves quickly. Your diet, environment, and hygienic habits influence what bacterial species make up your resident flora. The bacteria that make up our normal flora are essential to our health and well-being, but even with these bacteria also have the opportunity to cause harm to us through opportunistic infections.
Moments for Hand Hygiene during Routine Patient Care:
- Use of Alcohol-Based Hand Sanitizer
- Immediately before touching a patient.
- Before donning gloves & other PPE
- Before performing an aseptic task
- Before moving from work on a soiled body sight to a clean body sight
- After touching a patient or the patients immediate environment
- After contact with blood, body fluids, or contaminated surfaces
- Immediately after glove removal
- Immediately after leaving an isolation room
- Washing with Soap and Water
- When hands are visibly soiled
- After caring for a person with a known or suspected infectious diarrhea
- After known or suspected exposure to spores (e.g. B. anthracis & C. difficile)
Technique for Using Alcohol-Based Hand Sanitizer
- When using alcohol based hand sanitizer
- Put product on hands
- Cover all surfaces until hands feel dry
- This should take around 20 seconds
- When using soap and water
- When cleaning your hands with soap and water, wet your hands first with water, apply the amount of product recommended by the manufacturer to your hands, and rub our hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers.
- Rinse your hands with water and use disposable towels to dry. Use towel to turn off the faucet.
- Avoid using hot water, to prevent drying of skin.
- Other entities have recommended that cleaning your hands with soap & water should take around 20 seconds. Both times are acceptable, and the focus should be on cleaning your hands at the appropriate times
Further information regarding this subject matter can be found at: https://www.cdc.gov/handhygiene/providers/index.html