The Home Environment

Factsheet– Hand washing

This factsheet is suitable for domiciliary care, care homes, hospitals and hospices.

The importance of effective hand hygiene

Infection control experts advise that the washing of hands and high standards of hand hygiene is the most effective way of preventing the spread of infectious diseases in a health or care environment.The majority of infection in places such as healthcare settings and care homes is caused by unwashed or poorly washed hands which provide a perfect transfer route for micro-organisms such as bacteria. The effective washing ofhands or use of antiseptic hand rubs or alcohol hand rubs helps to remove those bacteria.

In a health or social care setting all staff should wash their hands regularly, including:

•between touching service users, no matter how minor the contact

•after handling any body fluids, waste or soiled items

•after handling specimens

•after using the toilet, after wiping the nose or sneezing

•before and after handling food.

Hand washing procedure

All staff should ensure that their hands are thoroughly washed and dried as follows:

•turn on water and adjust to a suitable temperature

•wet hands under running water

•apply liquid soap to wet hands

•thoroughly lather hand surfaces and rub hands vigorously for at least 15 seconds

•pay particular attention to nails, finger pads, thumbs and between fingers

•rinse hands thoroughly under running water to remove all traces of soap and then hold the hands downwards for water to drain from fingertips

•dry hands thoroughly by blotting with disposable paper towels or by hot air dispenser

•turn off water using elbow taps wherever possible.

Jewellery and watches

Rings increase the number of micro-organisms present on hands and increase the risk of tears in gloves. Hand and arm jewellery, including watches, hinder hand hygiene and should be removed. Arm jewellery, including watches, should be removed or pushed up above the wrist before performing hand hygiene.

Artificial nails or nail enhancements should not be worn by those giving care. Nails should be kept clean and short.

Hand washing facilities

In health care or care home settings, managers and supervisors shouldensure that premises are equipped with:

•an adequate number of sinks

•liquid soap dispensers or disposable pump dispensers

•disposable towel dispensers or warm air dispensers

•foot operated waste bins

•good practice guidelines and reminders by each sink.

Clinical treatment areas should contain sinks which have elbow-operated taps.

Disposable paper towels and liquid soaps should be used in preference tolinen towels or bar soaps which can become soiled. Mild soap containing emollients can help to prevent chapping of the skin from frequent washing.

All sinks and hand decontamination equipment should be regularly cleaned and maintained and liquid soaps and paper towels replaced when empty.

Disposable pump soap containers should not to be topped up as there is a risk of contamination

Alcohol/antiseptic hand rubs

Washing hands with ordinary liquid soap and warm water is considered adequate for routine use and for when hands are visibly soiled. Antiseptichand rubs or alcohol rubs can provide higher levels of infection control and should be used for sterile aseptic procedures such as changing dressings, wound care and catheterisation.

The use of an alcohol rub may be indicated in the following circumstances:

•when hands require additional antibacterial cleansing and are not visibly soiled

•before, during and after aseptic techniques

•where soap, water and towels are not available, as in some domiciliary care settings.

The use of an alcohol rub may also help reduce chapping and soreness of the hands where frequent hand washing is required.

An antiseptic hand rub or alcohol rub should be used as follows:

•do not wet hands

•dispense rub into the palm of the hand

•spread the rub thoroughly over both hands and wrists paying particular attention to nails, finger pads, thumbs and between fingers

•rub vigorously until dry.

The use of alcohol rubs for hand decontamination is not intended to replace washing hands with soap and water but rather to supplement hand washing where extra decontamination of the hands is required.