Clean Hands, Healthy Holidays: Protect Loved Ones from Illness with Effective Hand Hygiene

With the upcoming holidays and many family gatherings, one of the most important ways to protect yourself and loved ones is performing frequent hand hygiene. Good hand hygiene protects against sickness and disease such as the flu, respiratory syncytial virus (RSV), COVID-19, and other respiratory illnesses.

Hand hygiene has been known to be the single most critical measure for reducing transmitting organisms (infectious agents) to patients and to each other. Performing hand hygiene helps prevent the spread of infection and is one of the most effective parts of infection control in healthcare facilities. Hand hygiene includes several different methods: hand washing with soap and water, antiseptic hand wash, alcohol-based hand rub, and surgical antisepsis. The focus of this article will be on soap and water handwashing and alcohol-based hand rub for hand hygiene.

In healthcare settings, improper hand hygiene or not performing it at all has resulted in outbreaks of infections. Studies have shown a low adherence to hand hygiene, less than 40%. Some of the most popular reasons given for the lack of hand hygiene among healthcare personnel are:

• that products are inaccessible,
• the products cause skin irritation,
• healthcare providers are too busy to perform hand hygiene, and it interfered with patient care,
• workers were wearing gloves and felt hands were not contaminated,
• they just didn’t think about it,
• and they lacked the knowledge of when and how to perform hand hygiene.

Hand washing with soap and water should take place when hands are visibly soiled or dirty, before you eat, after going to the restroom, and after providing care for a patient with diarrhea or norovirus.

The proper sequence for hand washing is:

1. Wet hands first with water, apply plain or antimicrobial soap to hands and rub hands together to create a lather.
2. Vigorously rub hands for at least 20 seconds, covering all surfaces of hands and fingers – don’t forget the thumbs!
3. Rinse with water,
4. Dry with a disposable towel, and turn the faucet off (if manual) with the towel.
   1. The World Health Organization (WHO) states the entire hand washing process will take approximately 40-60 seconds.

Alcohol based hand sanitizers are preferred if hands are not visibly soiled. Hand sanitizers should have at least 60% alcohol or higher in them. The proper steps for using alcohol-based sanitizer are:

1. Apply the specified amount of the product from manufacturer label and rub hands together, covering all surfaces of hands and fingers.
2. Continue rubbing hands until all surfaces of the hands are dry. Healthcare personnel should follow the manufacturer’s instructions on the amount of sanitizer to be used. The WHO states the entire process of using hand rubs should take approximately 20-30 seconds.

Each facility should have and consider these elements to be included in a hand hygiene program. The infection control officer should involve staff in the selection and evaluation of hand hygiene products. Lotions should be considered and provided that are compatible with soaps and alcohol-based hand rubs.

Artificial nails and long natural nails should not be worn when providing direct patient care, as they compromise handwashing. Artificial nails have been linked to disease outbreaks in high-risk hospital settings. Bacteria can adhere to artificial nails, making it impossible to properly clean. They can also cause gloves to tear and are not recommended for workers.

Hand hygiene education should be provided at time of hire and no less than annually thereafter. Compliance with recommended hand hygiene practice should be monitored and findings reported back to staff on a routine basis. Input from staff on the hand hygiene program is an important part of compliance.

We have seen an increase in respiratory illnesses, including flu, RSV, and COVID in our country. During respiratory illness season healthcare workers should ensure and perform hand hygiene regularly throughout each day. Clean hands are an important defense against spreading infections. And remember to wash those hands at family gatherings, this will make happier holidays for all. Happy Holidays!

Stay tuned for next month’s continuation of the steps in instrument processing where we will cover sterilization and storage.