What is the recommended method for handwashing?

Recommended Method for Handwashing

The recommended method for handwashing is to wet hands first with water, apply soap, rub hands together vigorously for at least 15 seconds covering all surfaces of hands and fingers, rinse with water, and dry thoroughly with a disposable towel, using the towel to turn off the faucet. 1

When to Wash vs. When to Use Hand Sanitizer

Use soap and water when:

• Hands are visibly dirty or contaminated with blood/body fluids 1
• Before eating and after using the restroom 1
• After exposure to bacterial spores like Bacillus anthracis 1

Use alcohol-based hand rub when:

• Hands are not visibly soiled 1
• For routine decontamination in clinical settings 1

Proper Handwashing Technique

1. Preparation:

   • Use lukewarm or cool water (avoid hot water which increases skin irritation) 1
   • Remove rings, watches, and bracelets if performing surgical hand antisepsis 1

2. Washing Steps:

   • Wet hands first with water 1
   • Apply manufacturer-recommended amount of soap 1
   • Rub hands together vigorously for at least 15 seconds 1
   • Cover all surfaces including:
     • Palm to palm
     • Back of hands
     • Between fingers
     • Fingertips
     • Thumbs
     • Wrists
   • Pay special attention to fingertips, hypothenar eminence, and dorsum of the hand (commonly missed areas) 1

3. Rinsing and Drying:

   • Rinse hands thoroughly with water 1
   • Dry completely with disposable towel 1
   • Use towel to turn off faucet 1

Hand Sanitizer Technique

When using alcohol-based hand sanitizer:

• Apply product to palm of one hand
• Rub hands together covering all surfaces
• Continue until hands are dry 1
• Follow manufacturer's recommendations for volume 1

Common Pitfalls to Avoid

1. Skin Damage:

   • Using water that is too hot (>40°C) 1
   • Washing hands immediately before or after using alcohol-based products 1
   • Applying gloves when hands are still wet 1
   • Not moisturizing after handwashing 1, 2

2. Ineffective Cleaning:

   • Insufficient duration (less than 15 seconds) 1
   • Missing commonly neglected areas (fingertips, thumbs, between fingers) 1
   • Using multiple-use cloth towels (not recommended in healthcare settings) 1

3. Skin Care After Handwashing:

   • Apply at least 2 fingertip units of moisturizer to each hand after washing 1
   • Use fragrance-free moisturizers containing petrolatum or mineral oil 1, 2
   • Reapply moisturizer every 3-4 hours and after each handwashing 1, 2

Special Considerations for Healthcare Workers

• Decontaminate hands before and after patient contact 1
• Decontaminate hands before invasive procedures 1
• Decontaminate hands after contact with body fluids, mucous membranes, or non-intact skin 1
• Decontaminate hands after removing gloves 1
• When moving from contaminated to clean body sites during patient care 1

By following these evidence-based handwashing techniques, the risk of respiratory infections can be reduced by 16-24% 3 and nosocomial infection rates can be reduced by up to 40% 4, significantly improving patient outcomes related to morbidity and mortality.