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Handwashing

Video 12 of 14
3 minutes
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Handwashing is the most important infection control technique. Disinfect your hands whenever they are visibly dirty or contaminated and before having any contact with clients, putting on gloves, and performing any procedures. Also disinfect your hands after having contact with a client’s skin; having contact with bodily fluids, excretions, non-intact skin, wound dressings, contaminated items; after using the bathroom; after touching garbage; and after removing gloves. So how do we practice proper handwashing? Well washing your hands with soap and water is the best way to reduce the number of germs in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs. Now let's cover the proper use of an alcohol based hand sanitizer. Remember, this is gonna be indicated when appropriate by your policy procedure, or by your industry. So there's a couple things we want to really make sure we clarify when using this alcohol based hand sanitizer for appropriate disinfection of our hands. And that is that we need enough in our hand that it fills the palm of one hand. We're going to then spread this all around the palms, on top of the hands, at least for twenty seconds making sure to get it in around the cuticles, underneath the nail beds. If you have jewelry on, make sure that it's getting all the way underneath the jewelry, and then if you might have more particulate underneath there, you might have to remove the jewelry and clean that appropriately as well at a later point. But we want to get all the way around, all around the wrists. All the little wrinkles in our hands and we're going to continue to work this into our hands and skin until dry or at least twenty seconds. Now, if you have a watch on, which is very appropriate for medical personnel or people that have to be able to watch the second hand, and you think that it could be contaminated, we'll remove this using proper personal protective equipment before we do this, and then sanitize the jewelry or the objects as appropriate following the engineering controls and the work practice controls covered under the bloodborne pathogens rule. Use soap and water if the hands are visibly dirty. Use disposable towels to turn the sink faucet on. Thoroughly Wet your hands with water. Apply soap. Rub your hands together for at least 20 seconds, covering all surfaces. Be sure to cover the backs of your hands, between your fingers, and under your nails. Rinse under running water and dry with disposable towel. Use the towel to turn off the faucet.

Hand washing is the most important and effective infection control technique. And while all of you already wash your hands regularly, in this lesson we're going to teach you the proper ways to wash and disinfect your hands to greatly reduce your chances of contamination.

When Should You Wash Your Hands?

Wash your hands whenever they're visibly dirty, but also:

  • Before having any contact with clients/patients
  • Before putting on your gloves
  • Before performing any procedures
  • After contact with client's skin, bodily fluids, excretions, non-intact skin, wound dressings, and contaminated items
  • After using the bathroom
  • After touching garbage
  • After removing your gloves

Proper Hand-Washing Technique

Pro Tip #1: In a world filled with technological advances and new and improved items at every turn, the old standard when it comes to handwashing is still the superior choice – soap and water – as it's still the best way to reduce the number of germs in most situations.

  1. Use a disposable paper towel to turn on the sink faucet.
  2. Thoroughly wet your hands.
  3. Apply a generous amount of soap.
  4. Rub your hands together, covering all the surface areas – backs of hands, between fingers, under nails – for at least 20 seconds.
  5. Rinse your hands under the running water.
  6. Dry your hands with a disposable paper towel.
  7. Use that towel to turn off the sink faucet.

If soap and water aren't available, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Alcohol-based hand sanitizers will quickly reduce the number of microbes on your hands, but it won't eliminate all types of germs.

Proper Use of Hand Sanitizer

Hand sanitizers that are alcohol based are great options if soap and water aren't available. But make sure you work them into your skin as thoroughly as you would wash your hands with soap and water.

  1. Fill the palm of one hand with hand sanitizer, as you'll need enough to apply a very generous layer to both hands.
  2. Spread the hand sanitizer around your palms, top of hands, between fingers, and work it into every crevice or wrinkle, including cuticles, nail beds, and under rings. Don't ignore your wrists and try to cover all areas.
  3. Continue to massage the hand sanitizer into your hands for 20 seconds.

Pro Tip #2: All medical personnel should have a watch with a second hand, as there are numerous situations where you'll need to record the exact time or use that second hand to keep track of the time – like to see when 20 seconds has passed with the hand sanitizer.

On that note, if you suspect that your watch may have become contaminated in the course of helping a patient or cleaning up a scene, you're going to need to put that watch into the bloodborne equivalent of the concussion protocol.

This protocol could be different for everyone, based on their own unique work practice controls that are covered under the bloodborne pathogens rule. So, know the specifics for your situation.

However, in general, you'll want to remove the watch using proper personal protective equipment and sanitize and disinfect it appropriately.

A Word About Personal Protective Equipment

Personal protective equipment (PPE) is equipment that is appropriate for your job duties and should be available to you in your workplace. A PPE includes all specialized clothing, equipment, and supplies that keep you from coming in direct contact with infected materials. These include CPR breathing barriers, disposable gloves, gowns, masks, shields, and protective eyewear.

Disposable Latex-Free Gloves

Wear disposable, latex-free gloves for all patient contact. There are powder-free gloves available as well as disposable latex-free gloves made of vinyl. Also consider nitrile gloves, as many consider them the preferred option when working with bloodborne pathogens.

Eye Protection

Safety glasses with side shields are a great way to protect your eyes in certain situations. If there's a risk of splashing or spraying of bodily fluids, use goggles or a full-face shield, as they'll greatly reduce the risk of contamination of the mouth, nose, and eyes.

CPR Breathing Barriers

CPR breathing barriers include resuscitation masks, shields, and BVMs. CPR breathing barriers help protect you against disease transmission when performing CPR or giving ventilations to a patient.

Masks

A mask is a personal protective device worn on the face that's designed to cover at least the nose and mouth, and which helps to reduce the risk of inhaling hazardous airborne particles, gases, and vapors. A high-efficiency particulate air mask will filter out at least 95 percent of airborne particles. Remember that masks must be fit-tested to be effective.

Gowns

In situations where there are large amounts of blood or other possible infectious materials, consider wearing a disposable gown. If your clothing becomes contaminated, remove it and shower as soon as possible. And wash the clothes in a separate load.