Many of us have had moments where we didn’t wash our hands as thoroughly as we knew we should or skipped doing so entirely. If you’re guilty of this as well, you are not alone! In fact, studies show that compliance with hand hygiene best practices and recommendations remains low (1) even though established guidelines for handwashing and/or disinfection exist in most healthcare settings.
The reasons often aren’t malicious. Some studies show that situations of low compliance were those with a high activity level and/or those in which a physician was involved (2). Some people simply forget because it is not a habit, and others might not have easy access to places to wash or disinfect their hands. All of these reasons may cause us to act against the best of our knowledge.
However, it is universally acknowledged that good hand hygiene is one of the most important factors in preventing the spread of healthcare-associated infections. And to quote WHO “Hand hygiene saves millions of lives every year when performed at the right moments during health care delivery.” (6)
Or said differently – clean hands save lives!
Think that hand hygiene is simply about using water and soap? Think again! A holistic approach to hand hygiene includes the acts of washing, drying, and disinfecting your hands, as well as caring for skin and nails.
Besides the usual suspects, such as post-bathroom visits and after eating, there are five moments for hand hygiene that are particularly crucial in healthcare, according to WHO (4):
- Before touching a patient
- Before clean/aseptic procedures
- After exposure to bodily fluids
- After touching a patient
- After touching patient surroundings
When washing your hands, there are several things to consider. First, it is useful to be aware of the temperature of the water you’re using. Besides damaging the skin, using very hot water also decreases the effect of soap. The water temperature does not otherwise affect the quality of hand washing or the removal of dirt from the hands. The efficiency of the wash is dependent on using the correct handwashing method.
Second, after washing, it is also important to dry your hand thoroughly. Wet or moist hands transport more microorganisms than dry hands. Therefore, you should always dry your hands immediately after washing. However, your chosen hand-drying method also isn’t without importance when it comes to preventing the spread of infections.
Multi-use towels can spread microorganisms to the hands as well as the surroundings and contribute to the spread of infection. Meanwhile, hand dryers can spread microorganisms to the hands and the surroundings in a radius of up to 1.5. meters (5 feet). In addition, the warm air can actually increase the moisture levels on the hands, contributing to the growth of microorganisms.
When drying your hands, the most hygienic choice is single-use paper towels, as they do not spread microorganisms to the hands or the surroundings and can be disposed of immediately after use.
We recommend following the six steps below when washing your hands:
1. Rinse the hands under clean, running water, removing any visible dirt.
2. Apply enough soap to cover all hand surfaces including wrists. The risk of skin irritation is minimized when applying soap to wet hands.
3. Rub hands and wrists for at least 15 seconds.
4. Rub both thumbs, wash the surface of the nails with the hands closed and wash in between the fingers.
5. Rinse thoroughly hands with water.
6. Dry hands thoroughly with a single-use towel. Use the same towel to turn off the faucet.
However, washing with soap and water removes dirt but does not kill microorganisms, and excessive hand washing can dry out the skin and increase the risk of skin irritation and dermatitis.
Tip: Fatty lotions and moisturizers, or ointments prescribed by a healthcare professional, can help treat dermatitis caused by hand washing.
In healthcare, it is a must for professionals to disinfect hands after washing. Your hands should be dry before applying an alcohol-based disinfectant since disinfectants increase the skin’s permeability and contribute to breaking down the skin’s barriers. If the skin is damaged, it can act as a reservoir and entry port for pathogenic microorganisms.
For hand disinfection, an alcohol-based agent containing glycerol - Ethanol and isopropyl alcohol is used - Ethanol 70-85% is recommended for liquid hand disinfection and 80-85% for hand disinfectant gel.
Tip: Using a disinfectant with glycerol helps maintain an intact skin barrier by protecting the skin.
We recommend following the four steps below when disinfecting your hands:
1. Apply disinfection to visibly clean and dry hands, including wrists and possibly forearms.
2. The amount used should keep the hands moist for 30 seconds. Count on using at least 3 ml each time.
3. Distribute evenly on both hands, every finger, between fingers, palms and possibly forearms.
4. Continue rubbing until hands, wrists and forearms are completely dry.
When working in healthcare, frequent washing and disinfection of your hands, as well as wearing gloves for extended periods of time, can lead to damage to your skin and nails.
Our skin works as an antimicrobial defense mechanism that protects us against bacteria and viruses. Dry, chapped skin can lead to the development of ulcers and cuts that make it easier for bacteria to get in, and before you know it, you have incurred yourself an infection.
Therefore, it is important to check your skin daily and make sure it is well taken care of. Be sure to use a good lotion, preferably without perfume, to protect the skin on the hands and around the nails, and use an extra high-fat moisturizer during the night if your hands require extra care.
For more information on how to protect and treat your skin and nails go visit our creams and lotion range
Besides keeping your hands clean, it is also important to use gloves whenever a task dictates it.
Gloves should be worn by healthcare workers when performing any tasks related to personal hygiene and when handling bodily fluids or chemicals. They can be used for clean and unclean tasks to protect both caregiver and patient from contagion and contaminants. Just remember to:
- Put on gloves before starting the task
- Change the gloves when going from an unclean task to a clean task
- Throw the gloves away right after use
- Wash or disinfect hands immediately after completion of a task
For more information on gloves go to our gloves FAQ site
Test your knowledge of proper hand hygiene practices by answering the eight questions below.
“As long as you wash your hands, you will not get sick as easily”
True, but: Hand washing and hand hygiene is only as efficient as their timing. You have to choose the right time for hand washing to avoid getting sick. We recommend: before and after contact with the mucous membranes (mouth, nose, eyes), before and after patient contact, before and after food contact, and after the hands have become dirty, for example, after using the bathroom. Another good habit is washing hands after coughing and sneezing, which is mainly for the protection of others.
“Washing hands without soap is as effective as washing with soap”
False: Ordinary soap has no effect on microorganisms, but soap does help to dissolve dirt and other substances more easily from the skin. The physical effect of soap can be enhanced by increasing the friction and using warm water. (Note: too much friction and too hot water increase the risk of irritated skin and skin damage.
“It is not hygienic to use a hand dryer to dry your hands”
True: When you use a dryer, microorganisms on the hands and the dryer are also blown into the immediate surroundings. If others touch the inside of the blower with dirty hands, clean hands can become contaminated upon using the dryer. Paper towels are a more hygienic option.
“You have to wash your hands for at least 60 seconds”
True, but: Fixed times are used in standardized test methods to show effectiveness, but in practice, people only wash and rub their hands for about 10-20 seconds. While 60 seconds is generally recommended, studies show that washing for 60 seconds is more effective than 30 seconds, but 10 seconds is also more effective than 5 seconds.
So: try to aim for 60 seconds, perhaps by humming the chorus of your favorite song from beginning to end twice.
“Drying the hands is just as important as washing them”
Yes: Drying the hands is important to avoid irritated and dry skin, which increases the risk of cracks and infections. In addition, microbes can be more easily transferred to and from wet hands.
Preferably, use a paper towel without applying too much friction. This is more hygienic than a cotton towel or dryer.
“A block of soap works better than a soap dispenser”
False, but: Liquid soap from a dispenser has the advantage of not being contaminated with micro-organisms left behind by others. Microorganisms can survive on and in soap. In addition, liquid soap is more gentle on the hands, decreasing the risk of irritated skin.
“There are more bacteria on an average keyboard than on a toilet seat”
True, but: Although many studies have been done, they have little meaning and should be taken with a grain of salt. These studies often do not look at the type of micro-organisms and the time of breeding. Therefore, these types of comparisons are of little relevance. Everything in our environment contains microorganisms, including people: humans carry more microorganisms than human cells.
“You can prevent bacteria by avoiding handrails in the train or subway”
True, but the effect is minimal. Bacteria and microorganisms are present almost everywhere and stick to almost everything. There is also a risk of contamination from airborne droplets and subsequent contact with the mucous membranes. So, just use the handrails and wash and disinfect your hands as soon as possible afterward.
- https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/quantifying-the-hawthorne-effect-in-hand-hygiene-compliance-through-comparing-direct-observation-with-automated-hand-hygiene-monitoring/2BF6DCE0DC6274915D8C9214F711B592
- https://pubmed.ncbi.nlm.nih.gov/20088678/
- https://www.who.int/multi-media/details/how-many-health-facilities-have--50--hand-hygiene--80--water--90--toilets
- https://www.who.int/multi-media/details/your-5-moments-for-hand-hygiene-poster
- https://www.who.int/news/item/12-05-2023-first-ever-who-research-agenda-on-hand-hygiene-in-health-care-to-improve-quality-and-safety-of-care
- https://www.who.int/campaigns/world-hand-hygiene-day/2023
