Hand Hygiene

Hand hygiene is the best and most effective way to prevent the spread of infection. The 2021 National Patient Safety Goals from The Joint Commission encourages infection prevention strategy practices such as implementing the hand hygiene guidelines from the Centers for Disease Control.  Accepted methods for hand hygiene include using either soap and water or alcohol-based hand sanitizer. It is essential for all health care workers to use proper hand hygiene at the appropriate times, such as the following:

• Immediately before touching a patient
• Before performing an aseptic task or handling invasive devices
• Before moving from a soiled body site to a clean body site on a patient
• After touching a patient or their immediate environment
• After contact with blood, body fluids, or contaminated surfaces (with or without glove use)
• Immediately after glove removal[9]

Hand hygiene also includes health care workers keeping their nails short with tips less than 0.5 inches and no nail polish. Nails should be natural, and artificial nails or tips should not be worn. Artificial nails and chipped nail polish have been associated with a higher level of pathogens carried on the hands of the nurse despite hand hygiene.

Five Moments of Hand Hygiene

Five Moments of Hand Hygiene Expanded

When performing hand hygiene, washing with soap and water, or an approved alcohol-based hand rub solution that contains at least 60% alcohol, may be used. Unless hands are visibly soiled, an alcohol-based hand rub is preferred over soap and water in most clinical situations due to evidence of improved compliance. Hand rubs are also preferred because they are generally less irritating to health care worker’s hands. However, it is important to recognize that alcohol-based rubs do not eliminate some types of germs, such as Clostridium difficile (C-diff).

When using the alcohol-based handrub method, the CDC recommends the following steps. See picture below for a poster created by the World Health Organization.

• Apply product to the palm of one hand in an amount that will cover all surfaces.
• Rub hands together, covering all the surfaces of the hands, fingers, and wrists until the hands are dry. Surfaces include the palms and fingers, between the fingers, the backs of the hands and fingers, the fingertips, and the thumbs.
• The process should take about 20 seconds, and the solution should be dry.

WHO Handrub Poster

When washing with soap and water, the CDC recommends using the following steps. See picture below of a handwashing poster created by the World Health Organization.

• Wet hands with warm or cold running water and apply facility-approved soap.
• Lather hands by rubbing them together with the soap. Use the same technique as the handrub process to clean the palms and fingers, between the fingers, the backs of the hands and fingers, the fingertips, and the thumbs.
• Scrub thoroughly for at least 20 seconds.
• Rinse hands well under clean, running water.
• Dry the hands using a clean towel or disposable toweling.
• Use a clean paper towel to shut off the faucet.

WHO Handwashing Poster

By performing hand hygiene at the proper moments and using appropriate techniques, you will ensure your hands are safe and you are not transmitting infectious organisms to yourself or others.