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Hand Hygiene

Washing your hands is the most effective and efficient way to prevent infections. Whether you are a nurse, a patient or a member of the general public, knowing how to properly wash your hands and use alcohol based hand gels is essential to good health and prevention of many common illnesses including colds and flu.

Hand gels, otherwise known as alcohol based hand gels or hand cleansing gels, are readily available to purchase for home use and are prominently displayed in health care settings. Many public places also have hand gels readily available. Hand gels can be very effective in cleaning one's hands and lessening the risk of contamination, but they are not 100% effective.

Do you know the "rules" for use of a hand gel?

* Hand gels are not effective for c-diff (clostridium difficile), soap and
water is required(c-diff is an intestinal infection which causes severe
diarrhea)
* However, hand gels ARE very effective in most other instances if used
properly
* Do not use hand gels if your hands are visible soiled, use soap and water
* You may use hand gels up to 10-12 separate times before needing to use old
fashioned soap and water
* Use a dime sized amount of hand gel, using gentle friction rub into hands
and a hand-width size on the wrists
* Hand gels can cause drying and chaffing; use soap and water to wash hands
thoroughly before applying moisturizing hand lotion

Washing your hands is a basic skill all of us learned as children and when first entering nursing school. Why do so many health care professionals (less then half)not use proper hand hygiene? Some excuses include "Not enough time"; "I'm so busy"; "I forget"; "It's inconvenient"; or "It's not worth the effort".

Let's look at why there are no excuses.

* "Not enough time": hand gels can be used "on the run" and effective hand washing takes less than a minute (approximately 40 seconds).

* "I'm so busy": effective hand washing takes little time and prevents most cross contaminations. If you or a family member became ill due to your lack of proper hand hygiene, how much time and money would be lost fighting that infection? Time lost from work and/or school, seeing the doctor, taking a prescription and missing important family activities. It will cost you both time and money in the long run - so wash your hands or use that hand gel!

* "Inconvenient": all health care facilities have hand washing stations throughout the facility and sinks available in patient rooms. Hand gel dispensers are readily available throughout facilities or you can purchase a small bottle of hand cleanser at the store for about $1 to carry in your pocket. What is more convenient then that?
* "Not worth the effort": 40 seconds of time for soap and water hand washing can prevent nosocomial infections from occurring (nosocomial infections are those infections obtained in a health care facility). The Centers for Disease Control (CDC) and World Health Organization (WHO) have estimated that just one MRSA (so called "super bug") infection would cost the hospital and patient over $60,000. Soap and water for a single hand washing event cost less than $0.25 and an entire large bottle of hand gel can be purchased for under $2, a small bottle for under $1. Which is "worth the effort" when put in those terms?

Steps to proper hand washing are simple and you should also teach your children and others the proper steps. It's as simple as 1, 2, 3, 4, 5!

1. Wet hands with warm running water, it should not be hot
2. Apply liquid soap
3. Scrub backs of hands, wrists, between fingers and under fingernails for about 20 seconds (the time it takes to sing your ABC's, Twinkle Twinkle Little Star or the Happy Birthday song).
4. Rinse with warm running water, never touching the inside of the sink.
5. Dry hands and turn off water using a dry towel so you do not recontaminate your hands on the dirty faucet handles.

If you use bar soap you must work up a good lather, rinse and build up another good lather before spending at least 20 seconds cleaning your hands and wrists. Bar soap can grow bacteria on the surface, by washing and rinsing you remove most bacteria.

We are role models and must not only ensure we use hand hygiene at work, but consistently perform proper hand hygiene wherever we are. What message do we give to those who know we are nurses but fail to use hand washing in public?

Are you a good role model for those around you? Use proper hand hygiene and help others get into the clean hands habit as well.

Have you washed your hands today?

I recommend the CDC's website on Hand Hygiene in Healthcare Settings.
http://www.cdc.gov/handhygiene/index.html

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