Natasha Wright, RN, MSN
DHEC HAI Nurse Consultant

While there won’t be a cake with several tiers, beautiful gowns or champagne toasts, hand hygiene is definitely a subject worthy of its own day to “celebrate.”

In the pursuit of preventing all healthcare-associated infections (HAIs), the S.C. Department of Health and Environmental Control (DHEC) and the South Carolina Hospital Association (SCHA) urge all health care facilities and organizations to join us in highlighting the single most important practice supported by evidence in helping eliminate cross-contamination and reduce HAIs—proper and thorough hand hygiene².

Up to 70 percent of HAIs that occur yearly could be prevented if health care workers follow recommended protocols, which include proper hand washing³. Even with all of the evidence of its effectiveness and emphasis placed on the importance of hand cleanliness, a 2010 study that examined research on global practices found that only roughly 40 percent of health care workers comply with recommended hand washing guidelines³.

A Few (Not-So-Fun) Facts:

1. Studies show that some health care providers practice hand hygiene less than half of the times they should. Health care providers might need to clean their hands as many as 100 times per 12-hour shift, depending on the number of patients and intensity of care. Know what it could take to keep your patients safe¹.
2. On any given day, about 1 in 25 hospital patients has at least one healthcare-associated infection. Many germs that cause these infections are spread from patient to patient on the hands of health care providers¹.
3. There are three areas most often missed by health care providers when using alcohol-based hand sanitizer: thumbs, fingertips and between fingers¹.
4. A few barriers to completely following recommended guidelines are³:

• Inconvenient placement of sinks and/or hand sanitizer dispensers, or empty soap or sanitizer dispensers;
• Health care workers concerned about drying out their skin;
• Overlooking hand cleanliness due to the workload of a health care worker and/or a chaotic environment;
• The belief that wearing gloves when providing care is sufficient in preventing the spread of germs.

Hand Sanitizer or Soap and Water¹?

1. An alcohol-based hand sanitizer is the preferred method for cleaning your hands when they are not visibly dirty because it:

• Is more effective at killing potentially deadly germs on hands than soap;
• Requires less time;
• Is more accessible than hand washing sinks;
• Reduces bacterial counts on hands;
• Improves skin condition with less irritation and dryness than soap and water.

2. Use soap and water when hands are visibly soiled and/or when working with a patient or an environment in which you may come into contact with contaminants.
3. Although the amount of time for proper hand washing with soap and water varies from 15 seconds to 30 seconds (depending on the study), hands should be vigorously scrubbed for a minimum of 15 seconds.
4. Remember “My 5 Moments for Hand Hygiene”^4:

• Before touching a patient;
• Before clean/aseptic procedures;
• After body fluid exposure/risk;
• After touching a patient;
• After touching a patient’s surroundings.

Still Room for Improvement

In a world where health care is continuously changing, one thing has remained constant—routine and thorough hand washing is essential for preventing the spread of germs (including the increasing threat of those resistant to antibiotics) and the development of HAIs in patients. While the health care field is far from the days when gloves were barely worn and hand hygiene was an afterthought, we are not at 100 percent compliance in our facilities. Whether it is through the use of the traditional soap and water or alcohol-based hand sanitizers, proper handwashing must continue to be highlighted and emphasized by all champions of infection prevention because it is one practice that will remain constant for years to come.

Useful Resources for World Hand Hygiene Day

Centers for Disease Control (CDC) Clean Hands Count Campaign

cdc.gov/handhygiene/index.html

World Health Organization (WHO) Save Lives: Clean Your Hands Campaign

Theme for 2017–Fight antibiotic resistance – it’s in your hands

who.int/gpsc/5may/en/

 References:

1. CDC. (2016). Show Me the Science. cdc.gov/handhygiene/science/index.html
2. Infection Control Today. (2017). infectioncontroltoday.com/topics/hand-hygiene.aspx
3. Saint, S. (2016). Hand washing stops infections, so why do health care workers skip it? theconversation.com/hand-washing-stops-infections-so-why-do-health-care-workers-skip-it-58763
4. WHO. (2017). My 5 Moments for Hand Hygiene. who.int/gpsc/5may/background/5moments/en/