Hand hygiene

Regular and effective hand hygiene is the single-most important thing you can do to protect yourself and others from infection.

Your hands naturally have germs on them.  Some live naturally on the hands, others are picked up as a result of touching objects or surfaces (e.g. tables, chairs, beds) as we go about our daily lives. This is quite normal and doesn’t pose a risk. But as you go about your role as a HCA during the in care settings, your hands will literally ‘pick up’ lots of other germs, and these can cause harm if they are passed to another person – such as a patient or client.  Hand hygiene aims to get rid of as many of these types of germs as possible.

Before we look at how to perform hand hygiene and the times when you must perform it, there is one thing we need to emphasise.

Hand hygiene involves not only washing your hands, but also drying them thoroughly.

You can wash your hands really well and remove the problem germs, but if you then walk away with your hands still damp, more germs will attach themselves and your effort will have been wasted. So always remember this simple equation:

Hand hygiene = hand washing + hand drying.

Alcohol hand gels can be used as an alternative to hand washing – you should follow the instructions for use on the gel packaging.

Hand hygiene process

Hand Hygiene WHO [PDF file 4.26Mb] [How to acess PDF files]

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Before we look at how to perform hand hygiene well, take a look at the diagram above. This shows the parts of the hands that are missed when health care workers perform hand hygiene sloppily. As you can see, the fingertips and the thumbs are among the most frequently-missed parts of the hand. And when you think of it, aren’t these the parts of the hand that are in most frequent contact with patients/clients?

Hand hygiene can be performed either with soap and water or with alcohol hand rubs, which are now widely available in all health care settings. There are slight differences in the processes followed for the two, and these will now be shown. But regardless of which method you’re using, it’s important that you first:

  • remove any wristwatches or other items of jewellery (so you can clean the skin they usually cover).
  • roll your sleeves up.

When to perform hand hygiene

There are numerous occasions during your day when you need to perform hand hygiene. Germs can get onto your hands by a number of means, including:

  • patients/clients coughing or sneezing close to you or touching your hands
  • touching surfaces, furnishings, fittings and equipment in the patient’s/client’s room or living space
  • handling waste products from the patient (urine, vomit, faeces or sputum, or items covered with these).

Here are some of the most important times for hand hygiene.

You must always wash and dry your hands (perform hand hygiene):

  • before and after any contact with the patient/client
  • after taking your gloves off.

You must also perform hand hygiene:

  • before putting on personal protective equipment and after taking it off
  • before giving the patient/client food or drinks
  • after making the patient’s/client’s bed
  • after helping the patient/client back from the toilet
  • after removing any waste from the patient’s/client’s living area.

And of course, you should perform hand hygiene:

  • before eating
  • after using the toilet
  • after covering your own mouth and nose while coughing or sneezing
  • after using a disposable tissue
  • when you start and finish work.

It’s really important to note, however, that there will be other times when you’ll feel you need to perform hand hygiene – it all depends on the situation you’re in and how you feel you can best protect your patient/client, your colleagues and yourself.

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