There’s More to Hand Hygiene Than Hand Washing

The simple washroom sign ‘Now wash your hands’ is literally a lifesaver. Millions of infections would be avoided if people took a moment to clean their hands correctly. Worryingly, the biggest source of this problem is in healthcare settings, such as hospitals.

A visit to hospital, a medical clinic or a dental surgery may not only bring healing, but also exposure to microorganisms that cause infection. Whenever there is physical contact between a patient and a member of the medical team, or a piece of equipment, there’s a risk of contamination. But the one action that would cut these dramatically is, according to the WHO, the correct and timely washing of hands.

On 5 May 2016 the World Health Organisation (WHO) ran its annual event to highlight the importance of hand hygiene with its SAVE LIVES: Clean Your Hands campaign. This year the message focused on infection prevention and control in healthcare environments.

Key facts shared by WHO on Hand Hygiene Day 2016

– 61% of healthcare workers do not clean their hands at the right moment.
– one in two surgical staff do not clean their hands at the right moment.

The secret to good hand hygiene comes not only from knowing how to wash your hands effectively, but from knowing when to wash your hands.

When to wash your hands

To help healthcare workers think about how often they should wash their hands, the WHO has identified five key moments when washing is appropriate. These are:

1. Before touching a patient
2. Before a clean or aseptic procedure
3. After exposure to body fluids, or the risk of exposure
4. After touching a patient
5. After touching patient surroundings

Infection control is really important in healthcare, and so too is efficiency. These five moments make it easier for anyone involved with healthcare to spend the right amount of time on hand hygiene. However, at each of these five points, multiple handwashes might be required, depending on the specific procedures being carried out.

In a busy healthcare environment you’ll be touching lots of different items in a short space of time: equipment, door handles, patient notes and other surfaces. Even a social handshake introduces the risk of infection. At every contact, it’s a good idea to consider the potential impact on hand hygiene.

How to wash your hands correctly

There are two methods of hand hygiene: hand sanitisers or soap and water.

The general advice is that when hands are visibly soiled, soap and water should be used. The washing should take no more than a minute. To be really effective, it needs to follow a procedure that ensures both hands are entirely clean.

Click here to download a WHO poster that demonstrates how to wash your hands.

When hands are not visibly soiled, use of a sanitiser, or handrub, is recommended. This is typically an alcohol-based gel that should contain at least 60% alcohol.

Click here to download a WHO poster that demonstrates how to use hand sanitiser.

Does handwashing really make a difference?

It can often be difficult to make the connection between hand hygiene and the health of patients, or indeed that of people working in healthcare. When there’s no obvious soiling, there are no clues to the infection risks being carried on your skin.

A few years ago, the NHS in Glasgow cut their infection rates across eleven hospitals and other healthcare units through a programme that included boosting awareness and practice of hand hygiene.

The initiative also raised patient confidence, by putting hand hygiene stations outside wards, along with information explaining its importance. Patients appreciated the direct and practical approach, and it made them feel more comfortable about being treated in those hospitals.

One of the issues the Glasgow programme had to overcome was the common misconception, particularly among staff, that there was no evidence to back the importance of hand hygiene. This lack of knowledge was addressed through training, using information from the WHO.

Poor hand hygiene is considered to be the major source of healthcare-associated infection (HCAI), which is where a patient becomes infected during the process of receiving healthcare.

Across Europe, over 4 million people a year are affected by HCAIs, meaning longer stays in hospital and increased pressure on hospitals and their staff.

By adopting and maintaining good practice in hand hygiene, you and others working in healthcare can help to bring that number down.

More downloadable (PDF) hand hygiene resources from the WHO:

Caring for a patient with a post-operative wound
Infographic – hand hygiene and the surgical patient journey
Promotional poster for hand hygiene – safe surgical hands
Poster – Surgical handrubbing technique
Caring for a patient with a venous catheter