15-Second Procedure Saves Lives (and you already know how to do it)

It Seems Simple, But…
If you discovered that one easy 15-second task, performed several times each day, could help protect your health and spare your family and friends from recurrent infections and disease, would you be willing to participate? Good. Wash your hands.

It’s hard to believe that something as easy as washing our hands could have an enormous impact on our health and on the health of our family, friends and other contacts, but it’s true. No matter how many times it’s repeated, “Wash your hands!!” remains a significant health care strategy.

At this year’s annual meeting of the Infectious Diseases Society of America in Chicago, the US Centers for Disease Control and Prevention (CDC) issued new guidelines to improve hand hygiene in health care settings. The CDC estimates that up to 2 million infections occur each year in hospital patients, and that about 90,000 of these patients die as a result of their infections. The CDC reports that fully half of those infections could be prevented by proper hand hygiene.

Alcohol-Based Handrubs
New to this year’s guidelines was the inclusion of alcohol-based handrubs in health care facilities. These handrubs address some of the problems encountered by health care workers when caring for patients, such as the lack of time for handwashing, the inconvenience or blockage of handwashing stations in the facility, skin irritation from frequent washing with soap, and simple forgetfulness. A small container of alcohol-based handrub carried in a pocket or a wall-mounted dispenser in an easily accessible location could mean the difference between life and death for a patient.

Really, Now: How Important are Clean Hands?
Regarding the issue of the importance of clean hands in a health care setting, Peter G. Sohnle, MD, Professor of Medicine (Infectious Diseases) at the Medical College of Wisconsin, reports, “A great many studies of this problem have shown that the responsible microorganisms are most frequently carried from patient to patient on the hands of hospital personnel. Therefore, clean hands are extremely important in the hospital setting.” Dr. Sohnle points out, however, that it is sometimes difficult for health care providers to wash their hands as often as is necessary. “We do try very hard, but there are some problems with standard soap and water washing. For one thing, it takes time. But probably more important is the potential damage done to the skin by repeated washing. Roughened or scaly skin may actually harbor more bacteria and could compound the problem.”

To that end, the CDC’s recommendation of alcohol-based handrubs could be a boon for those in health care settings, and, in turn, their patients. “They work quickly and produce less irritation to the skin than does soap and water washing,” says Dr. Sohnle. “Standard washing is still needed to remove obvious dirt or other substances, but in the majority of cases hands are visually clean when washed in the hospital setting.” He reports that at Froedtert Memorial Lutheran Hospital, new alcohol-based handrub containers have been mounted in most of the patient care areas. “Now we have an attractive alternative to the usual method of hand washing, although that is still available, too.”

The use of gloves does not eliminate the need for hand hygiene. Likewise, the use of hand hygiene does not eliminate the need for gloves. In health care settings, gloves reduce hand contamination by 70% to 80%, prevent cross-contamination and protect patients and health care personnel from infection. As with gloves, handrubs or handwashing should be employed before and after contact with each patient.

Recommendations for the Home
As far as cleanliness in non-health-care settings, Dr. Sohnle says that handwashing with soap and water remains a sensible strategy for hand hygiene in most situations. When hands are visibly soiled, he says, they need an old-fashioned soap-and-water washing. CDC recommendations for basic handwashing are as follows: When washing hands with soap and water, wet hands first with water, apply soap and rub hands together vigorously for at least 15 seconds, covering all surfaces of the hands and fingers, including underneath rings and fingernails. Rinse hands with water and dry thoroughly with a disposable towel. Use the towel to turn off the faucet.

For generally clean hands, or when soap and water are not available, alcohol-based handrubs can be an effective alternative. When using an alcohol-based handrub, the CDC recommends applying the product to the palm of one hand and rubbing hands together, covering all surfaces of hands and fingers, until hands are dry. Be sure to note that the volume needed to reduce the number of bacteria on hands varies by product, so read the product’s instructions.

Despite the fact that infections do occur in health care facilities, homes and public places, it’s reassuring to know that something as basic as washing our hands can be an effective tool against contamination. Wash your hands frequently, especially after using the bathroom, before eating, and when in contact with others; and use an alcohol-based handrub when soap and water are not available. These simple steps will go a long way toward protecting your good health – and the health of all those you touch.

P. J. Early
HealthLink Contributing Writer

This article includes information from the US Centers for Disease Control and Prevention.

For more information on this topic, see the HealthLink article The Facts about Handwashing.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.