{"id":1575,"date":"2024-09-26T18:29:17","date_gmt":"2024-09-26T22:29:17","guid":{"rendered":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/hand-hygiene-2\/"},"modified":"2024-09-27T13:39:23","modified_gmt":"2024-09-27T17:39:23","slug":"hand-hygiene","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/chapter\/hand-hygiene\/","title":{"raw":"2.4 Hand Hygiene","rendered":"2.4 Hand Hygiene"},"content":{"raw":"
Hand Hygiene Best Practices<\/h1>\r\n
Hand hygiene is the most important part of practice for health care workers and is the single most effective way to stop the spread of infections; failure to properly perform hand hygiene is the leading cause of hospital associated infections and the spread of [pb_glossary id=\"533\"]antibiotic resistant organisms (ARO)[\/pb_glossary] (BC Centre for Disease Control, 2014; WHO, 2009a). Hand hygiene is a general term used to describe any action of hand cleaning and refers to the removal or destruction of soil, oil, or organic material, as well as the removal of microbial contamination acquired by contact with clients or the environment. Hand hygiene may be performed using an [pb_glossary id=\"519\"]alcohol-based hand rub (ABHR)[\/pb_glossary] or soap and water.<\/p>\r\n\r\n
Hand Hygiene<\/h2>\r\n[caption id=\"attachment_1560\" align=\"alignright\" width=\"181\"]Figure 2.4.1<\/strong> Hands carry germs[\/caption]\r\n
Even if your hands appear clean, they may carry germs. Hands pick up [pb_glossary id=\"466\"]microorganisms[\/pb_glossary] (germs) in several ways. When people who are sick sneeze or cough, the germs that are making them sick are expelled into the air in tiny droplets. If these droplets get onto your hands, and then you touch your mouth, eyes, or nose without washing away the germs, you can pick up the infection.<\/p>\r\n
Washing your hands prevents you from getting sick and educes the risk of infecting others. If you don\u2019t wash your hands properly before coming into contact with others, you can infect them with the germs on your hands. Other people can also get sick from the germs unwashed hands leave on shared objects like doorknobs, keyboards, and other equipment in the home or workplace.<\/p>\r\n
Hand hygiene is all about keeping your hands clean and the skin healthy. This is done by:<\/p>\r\n\r\n
\r\n \t
Washing your hands with soap and water, or cleaning with alcohol-based hand rub (ABHR).<\/li>\r\n \t
Using moisturizer to protect your skin \u2014 this prevents chapping and skin breakdown.<\/li>\r\n \t
Not wearing jewellery or artificial nails \u2014 these interfere with cleaning your hands properly, and can harbor germs.<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_1560\" align=\"alignleft\" width=\"178\"]Figure 2.4.2<\/strong> Hand jewellery and false nails hide germs[\/caption]\r\n
Hand Jewellery and False Nails<\/h2>\r\n
Hand jewellery such as rings, bracelets, and watches interfere with proper hand cleaning and can hide germs. You should either not wear these to work or remove them when cleaning your hands. Long nails, false nails, chipped nail polish, and nail jewellery can also harbour germs, which is why most health care facilities have policies against health care providers wearing them.<\/p>\r\n\r\n\r\n[caption id=\"attachment_1560\" align=\"alignright\" width=\"213\"]Figure 2.4.3<\/strong> Change bandages regularly[\/caption]\r\n
Hand Care<\/h2>\r\n
It\u2019s important that you keep the skin of your hands in good health, so that it doesn\u2019t become dry or chapped and prone to\u00a0breakdown. You should use hand lotion to prevent your skin from becoming dry. If you suffer from frequent skin breakdown (dermatitis), you should consult your workplace health provider or doctor.<\/span><\/p>\r\n
If you have a cut on your hand, it\u2019s important to cover it with a bandage so that no germs get into it. Be sure to change the bandage regularly, as you can\u2019t properly clean a bandage, and you don\u2019t want a dirty bandage to become a way for germs to spread.<\/p>\r\n\r\n
Proper Methods of Handwashing<\/h1>\r\n
Although handwashing might seem like a simple task, you should follow these steps to thoroughly rid your hands of germs.<\/p>\r\n\r\n
What Kind of Soap to Use?<\/h2>\r\n
\r\n \t
Use plain soap that does not contain antibacterial agents. Plain soap will remove the dirt and grease that attract bad bacteria.<\/li>\r\n \t
Plain soap will not kill the good bacteria that live on the hands.<\/li>\r\n \t
Using antibacterial products unnecessarily increases the concentration of antibiotics in the water supply and in the environment and increases the risk of antibiotic resistant organisms.<\/li>\r\n \t
Liquid soaps are better than bar soaps, because germs can live on bar soaps.<\/li>\r\n<\/ul>\r\n[caption id=\"attachment_1560\" align=\"aligncenter\" width=\"165\"]Figure 2.4.4<\/strong> Liquid soap dispenser[\/caption]\r\n
Steps When Using Soap<\/h2>\r\n\r\n \t
Remove any hand or arm jewellery you may be wearing.<\/li>\r\n \t
Wet your hands with warm water.<\/li>\r\n \t
Apply plain soap to your hands and rub together for 20 seconds (the length of time it takes to sing \"Twinkle, Twinkle Little Star\" or \"Happy Birthday\").<\/li>\r\n \t
Wash the front and back of your hands, as well as between your fingers and under your nails.<\/li>\r\n \t
Rinse your hands well for 10 seconds under warm running water, using a rubbing motion.<\/li>\r\n \t
Wipe and dry your hands gently with a paper towel or a clean towel. Drying them vigorously can damage the skin.<\/li>\r\n \t
Turn off the tap using the paper towel so that you do not re-contaminate your hands. When using a public bathroom, use the same paper towel to open the door when you leave.<\/li>\r\n \t
If skin dryness is a problem, use a moisturizing lotion.<\/li>\r\n<\/ol>\r\n[caption id=\"attachment_1560\" align=\"aligncenter\" width=\"300\"]Figure 2.4.5<\/strong> Wash your hands thoroughly[\/caption]\r\n
\u00a0Steps When Using Alcohol-Based Hand Rub<\/h2>\r\n\r\n \t
Alcohol-based hand rubs or ABHRs are quick to use. They are especially convenient when soap and water are not available.<\/li>\r\n \t
Make sure your hands are dry, as wet hands will dilute the alcohol-based hand product.<\/li>\r\n \t
Use enough of the product to cover all the surfaces of your hands and\u00a0fingers.<\/li>\r\n \t
Rub your hands together until the product has evaporated.<\/li>\r\n \t
If dry skin is a problem, use a moisturizing lotion.<\/li>\r\n \t
Alcohol-based hand rubs don\u2019t work if your hands are greasy or visibly dirty. These products don\u2019t clean your hands and are not a substitute for handwashing. If your hands are visibly soiled, it is best to use soap and water.<\/li>\r\n \t
If it\u2019s not possible to wash with soap and water, use towelettes to remove the soil, then use an alcohol-based hand rub.<\/li>\r\n<\/ol>\r\n[caption id=\"attachment_1560\" align=\"aligncenter\" width=\"300\"]Figure 2.4.6<\/strong> Alcohol-based hand rub dispenser[\/caption]\r\n\r\n
\r\n
\u00a0The following videos, presented by the Provincial Infection Control Network of British Columbia (PICNet), demonstrate the techniques for hand hygiene using soapy and water and ABHR.<\/p>\r\n\r\n<\/header>\r\n
![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/germs-on-hands-181x300.jpg\")
Figure 2.4.1<\/strong> Hands carry germs[\/caption]\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/painted-nails-200x300.jpg\")
Figure 2.4.2<\/strong> Hand jewellery and false nails hide germs[\/caption]\r\n![\"Figure](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Band-aid-300x225.jpg\")
Figure 2.4.3<\/strong> Change bandages regularly[\/caption]\r\n![\"Figure](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/pexels-anna-shvets-3943901-200x300.jpg\")
Figure 2.4.4<\/strong> Liquid soap dispenser[\/caption]\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/hand-photography-flower-leg-wash-mouth-1395311-pxhere.com-scaled-1.jpg\")
Figure 2.4.5<\/strong> Wash your hands thoroughly[\/caption]\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/liquid-soap-scaled-1.jpg\")
Figure 2.4.6<\/strong> Alcohol-based hand rub dispenser[\/caption]\r\n\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/question-mark-gee7fa26e9_640-300x300.jpg\")
Figure 2.4.7<\/strong> Soap or ABHR?[\/caption]\r\n\r\nABHR contains 60% to 90% alcohol concentration and is recommended for hand hygiene in health care settings (CDC, 2012). ABHRs:\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/5-moments-full.png\")
<\/a> Figure 2.4.8<\/strong> Five moments of hand hygiene [Click to view image full size][\/caption]\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/5-moments-full-1-e1682456100167.png\")
\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.9-Hand-hygiene-with.jpg\")
Figure 2.4.9<\/strong> Hand hygiene with ABHR[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.10-scaled-1.jpg\")
Figure 2.4.10<\/strong> Remove gloves from box[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.11-Apply-first-glove-scaled-1.jpg\")
Figure 2.4.11<\/strong> Apply first glove[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.12-Apply-second-glove-scaled-1.jpg\")
Figure 2.4.12<\/strong> Apply second glove[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"Non-sterile](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/DSC_1514-150x150-1.jpg\")
Figure 2.4.13<\/strong> Non-sterile gloved hands[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/DSC_1516-150x150-1.jpg\")
Figure 2.4.14<\/strong> Grasp glove on the outside 1.25 cm below the cuff[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"Pull](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/DSC_1518-150x150-1.jpg\")
Figure 2.4.15<\/strong> Pull glove off[\/caption]\r\n\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/DSC_1520-150x150-1.jpg\")
Figure 2.4.16<\/strong> Inside out[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.17-Gather-inside-out-glove-in-remaining-gloved-hand-scaled-1.jpg\")
Figure 2.4.17<\/strong> Gather inside-out glove in remaining gloved hand[\/caption]<\/figure>\r\n<\/td>\r\n<\/tr>\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.18-Insert-finger-under-cuff-of-gloved-hand-scaled-1.jpg\")
Figure 2.4.18<\/strong> Insert finger under cuff of gloved hand[\/caption]\r\n\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.19-Remove-second-glove-scaled-1.jpg\")
Figure 2.4.19<\/strong> Remove second glove[\/caption]\r\n\r\n![\"\"](\"https:\/\/opentextbc.ca\/hcalabtheoryandpractice\/wp-content\/uploads\/sites\/430\/2024\/09\/Figure-2.4.20-Discard-used-non-sterile-gloves-scaled-1.jpg\")
Figure 2.4.20<\/strong> Discard used non-sterile gloves[\/caption]\r\n\r\n