Hand hygiene is considered the cornerstone of infection prevention and control.
Health care workers have three choices for hand decontamination:
In the literature the following terms can be found:
Hand hygiene targets the hand’s transient microbial flora be they (primarily) bacteria, viruses or fungi.
Total counts of bacteria on health care workers hands have ranged from 3.9 x 104 to 4.6 x 104.
Bacteria can survive on hands from minutes to hours e.g. S.aureus up to 150 min.
Viruses can survive on hands from minutes to hours e.g. Rotavirus up to 260 min.
Hand disinfection is to be performed as the preferred choice when hands are visible clean or dry. Hand washing is to be performed when hands are visible soiled and wet
Hand disinfection with an alcohol-based hand rub can reduce transient bacteria by 2.6 to 6.8 log 10 units.
Alcohol works by denaturation and coagulation of proteins, lyses the bacterial cells and disrupts the cellular metabolism. This either inactivates or kills the micro-organisms
The effect depends on the concentration and type of alcohol, formulation, the application time and the rubbing process. Link to the product - %, type of alcohol and texture (liquid, foam, gel).
How to disinfect hands:
Watch here how to disinfect your hands correctly
Hand wash with plain non-medicated soap has no antimicrobial activity but the process, together with the physical drying with towels physically removes but do not inactivate microbes from the hand as shown above. However, the hand wash procedure in itself carries the inherent danger of possible re-contamination by splash-back from the sink to the hands, the surrounding environment and health care workers’ clothes. The soap can get contaminated and lead to contamination of hands.
Hand wash can lead to damage of the skins barrier function and cause dryness and irritation. Hence it is important to consider the use of emollients by staff.
How to wash hands:
Hand wash should be followed by hand disinfection if a reduction of microorganism similar to hand disinfection is needed.
Watch here how to wash your hands correctly
Surgical hand antisepsis must be performed before invasive/surgical procedures
Surgical hand antisepsis is known in the literature as:
Surgical hand antisepsis using a plain non -medicated soap and followed by alcohol-based hand rub with persistent activity.
Surgical hand wash must be performed before the first invasive procedure or when hands and underarms are visible soiled or wet between invasive/surgical procedures.
Surgical hand disinfection must be performed on dry hands and forearms after surgical hand wash or when hands are visible clean and dry between invasive/surgical procedures.
Nail cleaner or - brushes are only to be used when hands or nails are visible soiled.
How to perform surgical hand wash:
How to perform surgical hand disinfection:
Surgical hand antisepsis using a medicated/antimicrobial soap: