Hand Hygiene: 101

General Information Regarding Hand Hygiene

According to the CDC (Centers for Disease Control and Prevention), hand hygiene is the single most important thing that an individual can do to avoid illness.

 

What is Hand Hygiene? Hand hygiene is a general term used to describe washing hands, the removal of soil from hands, and killing of pathogenic organisms on hands with an antiseptic agent, such as a hand sanitizer or surgical hand rub.

 

Are All Germs the Same? There are two basic types of germs on skin, transient flora and resident flora. Transient flora colonize the outer layers of skin. Transient flora is most effected by hand hygiene and is more likely than resident flora to cause infection. Resident flora are attached to the deeper layers of the skin and are difficult to remove with handwashing.

 

Proper Hand Washing Technique Wet hands with water Apply soap and rub hands together for at least 15 seconds Rinse and dry with disposable towel Use towel to turn off faucet.

Proper Waterless Hand Sanitizer Technique Apply to palm of one hand, rub hands together covering all surfaces until dry Volume should be based on hand size and manufacturer's recommendation

 

 

Healthy Skin

Healthy skin is vital to avoiding transmission and contraction of illness. The function of skin is to regulate water loss, protect tissue and the blood stream against microorganisms, and act as a barrier to the environment. Skin is made up of several layers.

 

Epidermis: The epidermis is the thin, strong, outer layer of the skin. The outermost portion of the epidermis is waterproof and prevents most bacteria, viruses, and other toxins from entering the blood stream.

 

Dermis: The dermis, directly under the epidermis, gives the skin its toughness and flexibility. The dermis contains nerves, sweat glands, sebaceous glands, hair follicles, and blood vessels.

 

Subcutaneous: Under the dermis is the subcutaneous layer which insulates the body from heat and cold, provides protective padding, and stores energy.

 

Test your knowledge of the anatomy of healthy human skin.

 

 

Hand Hygiene in Healthcare Settings

There is substantial evidence that proper and consistent hand hygiene in healthcare settings can reduce the incidence of infections.

 

Despite the evidence, hand hygiene compliance by healthcare workers remains rather low. To healthcare workers, the reasons for non-compliance seem rather intuitive; they include a lack of time, skin irritation, inconvenient dispensers, or a lack of education.

 

In 2002, the CDC Hand Hygiene Guidelines provided the following indications for hand hygiene:

When hands are visibly dirty, contaminated, or soiled, wash with non-antimicrobial or antimicrobial soap and water.

If hands are not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands.

 

The CDC Guidelines also provided specific indications for hand hygiene:

Before patient contact

Before donning gloves when inserting a CVC

Before inserting urinary catheters, peripheral vascular catheters, or other invasive devices that don't require surgery.

After contact with a patient's skin

After contact with body fluids or excretions, non-intact skin, wound dressings

After removing gloves

 

CDC Recommendations Regarding Fingernails and Artificial Nails:

Natural nail tips should be kept to 1/4 inch in length

Artificial nails should not be worn when having direct contact with high-risk patients (e.g. ICU, OR)