Hand Hygiene Guidelines for Healthcare Settings
January 2018
According to the Centers for Disease Control and Prevention (CDC), nearly two million healthcare–associated infections (HAIs) occur across the United States healthcare system each year, and many of these infections are transmitted by healthcare personnel. Hand hygiene is widely known to be the most important intervention for preventing HAIs. Proper technique can cut cold and flu risk,and prevent the spread of food borne illnesses and other infections.
Hand hygiene can mean cleaning your hands by:
- Washing them with soap and water
- Using an antiseptic hand wash
- Using an antiseptic hand rub (i.e. alcohol-based hand sanitizer including foam or gel)
Cleaning your hands reduces the spread of potentially deadly germs to residents and the risk of healthcare provider colonization or infection caused by germs acquired from the resident.
Alcohol-based hand sanitizers are the most effective products for reducing the number of germs. Antiseptic soaps and detergents are the next most effective, and non-antimicrobial soaps are the least effective. When hands are not visibly dirty, alcohol-based hand sanitizers are the preferred method for cleaning your hands in the healthcare setting. Soap and water are recommended for cleaning visibly dirty hands.
During Routine Care of Residents:
Wash with soap and water
- When hands are visibly dirty
- After known or suspected exposure to Clostridium difficile if your facility is experiencing an outbreak or higher endemic rates
- After known or suspected exposure to residents with infectious diarrhea during norovirus outbreaks
- If exposure to Bacillus anthracis is suspected or proven
- Before eating
- After using a restroom
Use an Alcohol-Based Hand Sanitizer
- For everything else
Clean your hands:
- Before eating
- Before and after having direct contact with a resident’s intact skin (taking a pulse or blood pressure, performing physical examinations, lifting the resident in bed)
- After contact with blood, body fluids or excretions, mucous membranes, non-intact skin, or wound dressings
- After contact with inanimate objects (including medical equipment) in the immediate vicinity of the resident
- If hands will be moving from a contaminated-body site to a clean-body site during resident care
- After glove removal
- After using a restroom
When using alcohol-based hand sanitizer:
- Put product on hands and rub hands together
- Cover all surfaces until hands feel dry
- This should take around 20 seconds
The CDC Guideline for Hand Hygiene in Healthcare Settings recommends these steps when cleaning your hands with soap and water:
- Wet your hands.
- Apply the amount of product recommended by the manufacturer.
- Rub your hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers.
- Rinse your hands with water.
- Use disposable towels to dry.
- Use towel to turnoff the faucet.
- Avoid using hot water, to prevent drying of skin.
Other entities have recommended that cleaning your hands with soap and water should take around 20 seconds. Either time is acceptable. The focus should be on cleaning your hands at the right times.
Wearing gloves is not a substitute for hand hygiene, as dirty gloves can soil hands. Always clean your hands after removing gloves.
Steps for Glove Use:
- Choose the rightsize and type of gloves for the task.
- Put on gloves before touching a resident’s non-intact skin, open wounds or mucous membranes,such as the mouth, nose, and eyes.
- Change gloves during resident care if the hands will move from a contaminated body-site(e.g., perineal area) to a clean body-site (e.g., face).
- Remove gloves after contact with a resident and/or the surrounding environment (including medical equipment) using the proper technique to prevent hand contamination.Failure to remove gloves after caring for a resident may lead to the spread of potentially deadly germs from one resident to another.
- Do not wear the same pair of gloves for the care of more than one resident.
Sources:
“HandHygiene in Healthcare Settings,” CDC
https://www.cdc.gov/handhygiene/index.html.
“Update:Citing Observations of Hand Hygiene Noncompliance,” The Joint Commission
“Handhygiene: Back to the basics of infection control,” IJMR
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249958/.
“95 percent of people wash their hands improperly: Are you one of them?”CBS News
https://www.cbsnews.com/news/95-percent-of-people-wash-their-hands-improperly-are-you-one-of-them/.
