Hand Hygiene 101: A Handy Guide for Healthcare Workers

The CDC provided us with their latest tips for how healthcare professionals can maintain proper hand hygiene. Take a look and see what steps you could add to your hand hygiene routine.

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As you might’ve noticed, there are a lot of opinions out there as to the “right” and “wrong” way to maintain good hand hygiene. Keep in mind, though, not all strategies were created equal, and some either gloss over or completely skip crucial steps in the sanitizing process. Given the critical role hand hygiene plays in patient safety, we decided to talk to the experts at the Centers for Disease Control and Prevention (CDC) to find out what they recommend.

Let’s Start With the Basics: What Do We Mean by “Hand Hygiene”?

According to the CDC, proper hand hygiene refers to methods used to remove or kill bacteria on the hands. They recommend two methods to routinely clean hands: Hand antisepsis using an alcohol-based hand rub or handwashing with soap and water.

Washing Hands vs. Alcohol-Based Sanitizer—Which Is Better?

The CDC argues that hand antisepsis is preferred in most clinical situations. However, hand-washing should be performed whenever your hands become visibly soiled or you may have been exposed to spores. Spores may not be killed or removed by alcohol- based hand rubs. C. difficile is an example of a diarrheal illness caused by spores.

To be most effective, alcohol-based hand rubs should have 60-95% alcohol. If you’re washing your hands, you may use antimicrobial soap, but this is not recommended over plain soap.

When Should You Wash Your Hands vs. Use Hand Sanitizer?

The CDC provided us with the following list of scenarios for when you should either perform hand antisepsis or wash your hands.

  • When to Perform Hand Antisepsis With Alcohol-Based Hand Rub
    • When hands are not visibly soiled;
    • Before having contact with a patient;
    • Before putting on gloves;
    • Before putting on gloves to insert a sterile device (e.g. urinary, intravenous catheters);
    • During care when moving from a contaminated body site to a clean body site;
    • After contact with the patient;
    • After contact with surfaces or equipment in the patient environment; and,
    • After removing gloves.
  • When to Wash Your Hands With Soap and Water
    • When hands are visibly soiled;
    • After using the restroom;
    • Before eating;
    • After caring for a patient with an acute diarrheal illness; and,
    • After touching surfaces or equipment used in the care of a patient with an acute diarrheal illness.

What’s the Right Way to Wash Your Hands?

The World Health Organization created a nine-step process for safe handwashing. At a high level, the steps are as follows:

  • Step 1: Wet your hands.
  • Step 2: Apply soap.
  • Step 3: Rub palms together for about five seconds.
  • Step 4: Rub your hands over each other for six seconds.
  • Step 5: Interlace fingers and rub the backs of your hands with your fingertips.
  • Step 6: Scrub each thumb for three seconds.
  • Step 7: Rub each palm with the fingertips of the other hand for three seconds.
  • Step 8: Rinse the soap off your hands until the water runs clear and you don’t see suds.
  • Step 9: Dry your hands with paper towels or a hand dryer.

If you want to learn more about the proper techniques for handwashing, or how to prevent your hands from drying out, take a look at our article, “9 Best Handwashing Steps for Nurses.”

What’s the Best Way to Apply Hand Sanitizer?

When applying the hand sanitizer, make sure to:

  • Apply the appropriate amount of sanitizer to the palm of one hand. (The label should guide you on the recommended amount.)
  • Rub along palms, thumbs, fingers, and backs of hands;
  • Continue rubbing until all hand sanitizer is absorbed and your hands are dry (about 20 seconds).

Some Additional Hand Hygiene Tips From the CDC

The CDC provided us with a few extra tips for maintaining proper hand hygiene:

  • Keep Your Hands Healthy
    • Short, natural fingernails harbor less bacteria than artificial or painted fingernails, especially if fingernail polish is chipped. Follow your healthcare facility policy about fingernails.
    • Protect your skin by only using lotions provided by your healthcare facility. Do not bring lotions from home as they may not be compatible with the products provided at work.
  • Wear Gloves to Protect Yourself and Your Patients
    • Use gloves according to Standard Precautions, when providing care involving water, and when caring for a patient with an acute diarrheal illness.
    • Change gloves and perform hand hygiene during care whenever the gloves may become contaminated and in between patient contacts.
    • Gloves reduce hand contamination, but don’t eliminate it.
    • Wearing gloves does not replace the need to perform hand hygiene. Hands may become contaminated during glove removal.

The views expressed in this article are those of the author and do not necessarily reflect those of Cinch™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice. For our full disclaimer, click here.

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