Hand Washing
Hand washing is the single, most critical measure for reducing the risk
of transmitting organisms to patients and health care providers. The need for
proper hand hygiene procedures is critical. Below are some tips in considering
when, how and what to use when hand washing.
According to the 2003 Centers for Disease Control (CDC) Guidelines for
Infection Control in Dentistry, there are specific instances when hand hygiene
should take place. Indications for hand hygiene include:
- when hands are visibly soiled
- after barehanded touching of inanimate objects likely to be contaminated by blood, saliva, or respiratory secretions
- immediately after removing gloves
- before and after treating each patient
- before donning gloves
Hand washing is performed often throughout the day, and knowing what to use
is also important. The CDC guidelines state, "Perform hand hygiene with either
a non-antimicrobial soap or antimicrobial soap and water when hands are visibly
dirty or contaminated with blood or other potentially infectious material.
If hands are not visibly soiled, an alcohol-based hand rub can also be used."
Antimicrobial soaps are known to kill germs better than non-antimicrobial
soaps. Therefore, it is better to use antimicrobial soaps where there is patient
contact with blood or saliva.
Alcohol-based hand rubs or hand sanitizers help reduce the time needed to
decontaminate hands, particularly when a sink is not readily available.
They have also been shown to improve hand hygiene compliance. However, if hands
are visibly soiled or in contact with potentially infectious material, then a
wash with soap and water is required. Most alcohol-based hand rubs contain
emollients to prevent the alcohol from drying the skin. Multiple uses will
create a buildup of emollients that should be washed off with soap and water.
The correct procedure for hand washing with soap and water is as follows:
- Moisten hands with warm water.
- Apply lotion or liquid soap.
- Thoroughly wash all surfaces of hands and wrists for 10-15 seconds, using friction and vigorous action and paying special attention between the fingers and around the nails (see illustrations).
- Rinse hands well, allow water to continue running.
- Take two paper towels and thoroughly dry hands.
- Use paper towels to turn off the faucets, discard towels in plastic-lined trash cans.
Step 6 may seem like overkill, but this step helps minimize the risk of
immediately recontaminating hands. Bacteria and germs will multiply in
moist areas and can multiply on faucets, doorknobs, etc. This reinforces the
importance of using no-touch soap and towel dispensers when possible.
Practicing good hand hygiene is a critical step in reducing the risk of
cross-contamination in any health care environment.
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