From the Guidelines
The primary purpose of hand washing, or hand hygiene, is to prevent the transmission of infectious agents and reduce the risk of healthcare-associated infections, by decontaminating hands with either soap and water or an alcohol-based hand rub, before and after patient contact, and after contact with bodily fluids or contaminated surfaces. The indications for hand hygiene include when hands are visibly soiled, after barehanded touching of inanimate objects likely to be contaminated, before and after treating each patient, before donning gloves, and immediately after removing gloves 1. To implement hand hygiene:
- Wash hands with soap and water if hands are visibly soiled or contaminated with blood or other body fluids, or use an alcohol-based hand rub if hands are not visibly soiled 1.
- Use an alcohol-based hand rub for routinely decontaminating hands in all other clinical situations, unless hands are visibly soiled, in which case soap and water should be used 1.
- Perform hand hygiene before and after each patient contact, and after contact with bodily fluids or contaminated surfaces 1.
- Use proper hand hygiene technique, including rubbing hands together to cover all surfaces, and following the manufacturer's instructions for the use of alcohol-based hand rubs 1. It is essential to prioritize hand hygiene in healthcare settings to reduce the risk of transmission of infectious agents and prevent healthcare-associated infections, as supported by the most recent and highest quality study 1.
From the Research
Purpose of Hand Washing (Hand Hygiene) Intervention
The primary purpose of hand washing (hand hygiene) intervention is to reduce the transmission of nosocomial infections in hospitals and healthcare settings 2, 3, 4, 5, 6. This is achieved by removing microorganisms from the hands of healthcare workers, which is a critical step in preventing the spread of healthcare-associated pathogens.
Mechanisms of Hand Hygiene
Hand hygiene can be achieved through various mechanisms, including:
- Washing hands with antimicrobial soap and water (surgical scrub) 2
- Using alcohol-based hand rubs, which have been shown to be more effective, less irritating, and requiring less time than traditional handwashing with non-medicated soap or other antiseptic agents and water 2, 3
- Using a combination of 61% ethanol and 1% chlorhexidine gluconate (CHG), which has been shown to produce residual antibacterial properties on the skin 3
Effectiveness of Hand Hygiene Interventions
Studies have shown that hand hygiene interventions can be effective in reducing the transmission of nosocomial infections, including:
- Reducing microorganisms from hands of personnel more effectively than traditional handwashing with non-medicated soap or other antiseptic agents and water 3
- Reducing infection rates and colonisation rates in healthcare settings 4
- Improving hand hygiene compliance among healthcare workers, particularly when multimodal interventions are used, including increasing the availability of alcohol-based hand rubs, education, reminders, performance feedback, administrative support, and staff involvement 4
Comparison of Handwashing and Alcohol-Based Hand Disinfectants
Some studies have compared the effectiveness of handwashing with soap and water versus alcohol-based hand disinfectants, with findings suggesting that:
- Handwashing with soap and water may be more effective than alcohol-based hand disinfectants in removing noroviruses from hands 5
- Alcohol-based hand disinfectants may be less effective against certain viruses, such as noroviruses, compared to handwashing with soap and water 5
Importance of Hand Hygiene in Healthcare-Associated Infection Prevention
Hand hygiene is considered the leading measure for preventing the spread of antimicrobial resistance and reducing healthcare-associated infections (HCAIs) 6. However, healthcare worker compliance with optimal practices remains low in most settings, highlighting the need for continued education, promotion, and implementation of effective hand hygiene interventions.