When performing hand hygiene when is it necessary to use soap and water instead of an alcohol based
Original Editor -Rachael Lowe Show
Top Contributors - Rachael Lowe, Tony Lowe, Naomi O'Reilly, Candace Goh, Kim Jackson, Wanda van Niekerk, Shaimaa Eldib, Tarina van der Stockt, Simisola Ajeyalemi, Lucinda hampton, Jess Bell, Nupur Smit Shah and Wendy Walker Introduction[edit | edit source]Hand Hygiene is a general term that applies to either handwashing, antiseptic hand-wash, antiseptic hand rub, or surgical hand antisepsis.[1] The Centers for Disease Control and Prevention (CDC) define these activities as the following:
Washing hands with soap and water is recommended for visibly soiled hands[4] and is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitiser that contains at least 60% alcohol. These sanitisers are the most efficacious agents for reducing the number of bacteria and viruses on hands and are recommended for routine decontamination of hands for all clinical indications, except when hands are visibly soiled.[4] Clean hands are a simple effective approach to reducing the spread of infections from one person to another and throughout an entire community - from your home and workplace to childcare facilities and hospitals.[5] Importance of Hand Hygiene[edit | edit source]Normal human skin is colonised with microorganisms which, although varying considerably from person to person, are often relatively constant for any specific person. On the hands, there are two categories of flora[4]:
Handwashing Education in the Community:
Indications for Hand Hygiene[edit | edit source]The CDC[11] describes the following indications for handwashing and hand antisepsis:
Methods of Hand Hygiene[edit | edit source]Get the poster here Get the poster here Washing with Soap[edit | edit source]There are 5 steps to proper handwashing[12]:
Which soap should be used? Antibacterial soap is not more effective in preventing Covid infection than regular plain soap.[14] [15] Thus, in the home and public, non-healthcare settings plain soap is recommended. Taking the time to wash your hands is what makes it effective. When available, liquid soap is more preferable than a bar of soap as it reduces the risk to spread infection from one person to another. However, according to the CDC either bar soap or liquid soap will do.[14] What You Need To Know About Handwashing from the CDC: [16] Handwashing Video from the WHO: [17] Alcohol-Based Hand Sanitiser[edit | edit source]When using alcohol-based hand sanitiser:
[18] Surgical Hand Antisepsis[edit | edit source]This is performed preoperatively by surgical personnel to eliminate transient and reduce resident hand flora:
Skin Care[edit | edit source]If skin health is suffering, it is recommended that lotions and creams be used to prevent irritation. Factors Affecting Adherence[edit | edit source]There are many factors that affect healthcare professionals' adherence to hand hygiene practices. The CDC adapted findings from Pittet[19] to come up with the following reasons for variable adherence. Observed risk factors for poor adherence to recommended hand-hygiene practices:
Glove Use[edit | edit source]
Considerations for Hand Hygiene in Disasters and Conflicts[edit | edit source]Hygiene is especially important in disasters and conflict settings such as a flood, hurricane, or earthquake, but finding clean, safe running water can sometimes be difficult. If your tap water is not safe to use, wash your hands with soap and water that has been boiled or disinfected. A temporary hand washing station can be created by using a large water jug that contains clean water (for example, boiled or disinfected).[20] Gloves are often used inappropriately in disaster and conflict settings. Even if in short supply, gloves are single use and should be disposed of safely after patient contact and not be reused. Examination gloves are only indicated in situations where there is a risk of direct exposure to blood, body fluids, excretions or items that are soiled with such materials. Gloves are not required for routine patient contact where there is no risk of contact with blood or body fluids, or a contaminated environment.[20] Resources[edit | edit source]
References[edit | edit source]
When should you use soap and water instead of alcohol based product when performing hand hygiene?Keep your hands clean! Use an alcohol-based handrub when your hands are not visibly soiled. Wash your hands with soap and water when your hands are visibly soiled.
When should soap and water be used for hand hygiene?Healthcare personnel should wash their hands for at least 20 seconds with soap and water when hands are visibly dirty, before eating, after using the restroom, and after caring for people with infectious diarrhea during outbreaks.
When should you not use alcohol hand rub?Alcohol based hand rub (ABHR) is a gel, foam or liquid containing one or more types of alcohol that is rubbed into the hands to stop or slow down the growth of microorganisms (germs). Do not use ABHR if you are caring for a resident who has sickness or diarrhoeal illnesses such as norovirus or Clostridioides difficile.
Why should you use soap to wash hands instead of water alone?Water alone does not dislodge them, but soap helps break down germ-carrying oils. Soap also facilitates rubbing and friction which can remove germs from the hands, and so that germs can be rinsed away with water. Using soap also adds to the time spent washing and ensures a more effective wash.
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