I know you think you know all about hand hygiene and standard precautions, and so you should! They are the basic steps every healthcare worker should practice every day, everywhere! BUT do you practise them correctly and consistently?!
As nurses, it is our job to ensure that every resident receives safe care, every time any care is provided. Unfortunately, from what I have observed in many facilities where I have undertaken environmental IPC audits, some components of standard precautions are not carried out effectively.
For this blog, we’re going to focus on how people can improve their hand hygiene technique quickly and easily to help reduce infections in their facility.
Hand hygiene: the linchpin of standard precautions
Hand hygiene is probably the most important component of standard precautions. This is because up to 80% of microorganisms are transmitted via our hands. But from what I have observed, hand hygiene is not always done at appropriate times or in an effective manner.
We talked a little bit about the 5 Moments of Hand Hygiene in our recent blog on hand hygiene compliance. This is because the 5 Moments outline the critical points in the provision of care. These five moments are where compliance with effective hand hygiene is required for the safety of the resident and healthcare worker.
Despite the emphasis on providing care with clean hands, the evidence continues to demonstrate that we think we clean our hands more often than we actually do. For nurses, as well as all healthcare personnel, it is important that there be a clear knowledge regarding who performs hand hygiene, when it should be performed, how it should be performed, under what conditions, and with what products.Infection Prevention and Control Core Practices: A Roadmap for Nursing Practice
However, the 5 Moments are not the only time that hand hygiene should be performed. There are plenty of other situations where hands should be washed (and as thoroughly as you would during one of the 5 Moments!). These include, but aren’t limited to:
- before starting/leaving work
- before and after eating/handling drinks
- before and after eating/handling food
- before and after using a computer, tablet or mobile device
- after visiting the toilet
- etc. etc. etc.
Four ways to improve hand hygiene
So, what do we get so wrong when we are performing hand hygiene? It is the actual technique. Effective hand hygiene relies on appropriate technique/method as much as on the selection of the correct product, if not more. Inappropriate technique can lead to failure of hand hygiene measures to effectively remove or kill microorganisms on the hands, despite the superficial appearance of having complied with hand hygiene requirements. With that in mind, here are four quick ways to improve hand hygiene effectiveness.
1. Wash/rub your hands for longer
The first problem with hand hygiene is that we don’t perform it for long enough. For example, don’t just squirt on a bit of ABHR and give your hands a bit of a half-hearted rub then move onto your next task. NO! You must rub your hands and wrists all over, using the correct method you have been taught, until your hands are completely dry. No waving them around to make them dry quicker either!
2. Wash/rub more vigorously
The second place where we can fail is how thoroughly we rub (or rather how poorly) during hand hygiene. You must vigorously rub your hands together, creating friction; this is how you will remove the microorganisms. Many people lose this momentum as they navigate jewellery and watches etc. on their hands, which leads us to our next point…
3. Remove obstacles instead of working around them
The third point of hand hygiene failure is not exposing all the surfaces of hands and wrists to the product being used. This happens because people are still wearing watches, bracelets, rings with stones, nail varnish, etc., preventing the hands and wrists from being fully exposed to the hand hygiene product and limiting the rubbing and creation of friction. Proper hand hygiene is a commitment, so be committed and remove those things that are compromising your hand hygiene technique.
4. Dry your hands properly
Last but not least, we must ensure our hands are completely dry, whether it is after soap and water hand hygiene, or using ABHR. When using soap and water, dry your hands thoroughly with paper towel. With ABHR, rub your hands together and rub your wrists until your hands and wrists are completely dry. I have observed a person working in aged care apply the ABHR, rub their hands together a couple of times then wipe the excess on their trousers?? Seriously!
Each individual’s action in performing hand hygiene correctly, and therefore complying with standard precautions, reduces or even stops the transmission of microorganisms via your hands. When hand hygiene protects not only our patients but also ourselves, it’s crucial that we make the effort to perform the proper technique, and do it as effectively as we can. If you’re struggling to explain the importance of proper hand hygiene to staff, Bug Control’s Hand Hygiene Training Kits will show everyone the areas they’re missing during hand hygiene.