From the Guidelines
Proper hand hygiene involves washing hands with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer containing at least 60% alcohol, with key times for hand hygiene including before and after patient contact, before aseptic procedures, after body fluid exposure, and after touching patient surroundings. According to the most recent guidelines, hand hygiene is crucial in preventing the spread of infections, and the mechanical action of washing removes dirt and microbes, while soap disrupts bacterial cell membranes, and alcohol-based sanitizers work by denaturing microbial proteins 1.
Key Times for Hand Hygiene
- Before patient contact
- Before aseptic procedures
- After body fluid exposure
- After patient contact
- After touching patient surroundings
- Before and after preparing food
- Before eating
- After using the bathroom
- After blowing your nose or coughing
- After touching garbage
- Before and after caring for someone who is sick
- After changing diapers
- After touching animals
Hand Hygiene Techniques
- Wash hands with soap and water for at least 20 seconds, scrubbing all surfaces of the fingers, hands, and wrists
- Use an alcohol-based hand sanitizer containing at least 60% ethanol or isopropyl alcohol, rubbing over all surfaces of the fingers, hands, and wrists until the sanitizer has dried, approximately 30 seconds
The importance of hand hygiene in healthcare settings is emphasized by the World Health Organization's "5 Moments" for hand hygiene, which are supported by studies such as 1 and 1. However, the most recent and highest quality study, 1, provides the most up-to-date guidelines for hand hygiene, prioritizing the use of alcohol-based hand sanitizers and soap and water for hand hygiene. Regular hand hygiene significantly reduces the spread of respiratory infections, gastrointestinal illnesses, and healthcare-associated infections.
From the Research
Hand Hygiene Guidelines
- Hand hygiene is vital for preventing healthcare-associated infections and ensuring patient safety 2
- The World Health Organization Hand Hygiene Knowledge Questionnaire is a validated tool used to assess hand hygiene knowledge, beliefs, and practices among healthcare professionals 2
- Key aspects of hand hygiene guidelines include:
- Using alcohol-based hand sanitizer routinely, with 88% of healthcare professionals reporting its use 2
- Correctly identifying the minimum time for alcohol-based sanitizer to kill germs, although only 67% of participants did so 2
- Emphasizing hand hygiene after patient contact, exposure to body fluids, or contact with the patient's surroundings 2
- Using both hand rubbing and handwashing for specific scenarios, such as before injections 2
Effective Hand Hygiene Products
- Alcohol-based hand sanitizers are effective in reducing healthcare-associated infections, with ethanol plus chlorhexidine gluconate showing significantly lower aerobic bacterial counts on hands of healthcare workers compared to ethanol-only products 3
- Alcohol-based hand sanitizers can be effective even on hands soiled with dirt and cooking oil, reducing levels of Escherichia coli by a mean of 2.33 log colony forming units (CFU) per clean hand 4
- Multi-component interventions that include alcohol-based products can achieve sustained hand hygiene compliance and reduce infection rates 5
Challenges and Areas for Improvement
- Persistent misconceptions and knowledge gaps regarding germ transmission and hand rubbing efficacy require targeted interventions 2
- Adherence rates and technique remain suboptimal, with greater attention to hand hygiene technique needed 6
- Combining automated hand hygiene monitoring systems with direct observations is a promising strategy to yield accurate estimates of hand hygiene adherence rates 6