With the rapid spread of Novel Corona Virus, now more than ever, seems like a great time to review the basics of handwashing, especially when working in a healthcare setting.
The simple task of handwashing is a practice that is considered vital in all instances of infection control. According the Handbook of Nursing Procedures, handwashing is “the single most important procedure for preventing infection.” In order to be effective in controlling infection, handwashing must be done often and it must be done well. As a caregiver, a major part of your work involves contact or touching the people in your care. This means that you will also come into contact with a number of pathogens. These are easily picked up on your hands when you touch people or objects around them. This is the most common way pathogens are spread.
For example, if you wash someone’s face, you may touch fluids from the eyes, mouth or nose. These fluids may contain pathogens. These organisms may then be spread to other people, yourself, or objects around you. Handwashing is the number one way to reduce the spread of disease-causing microorganisms.
Most pathogens can be easily removed from your hands using plain soap and water. The importance of handwashing should not be taken lightly. It should
never be avoided to save time no matter how busy you become. Many shortcuts are required in the art of nursing to help the nurse and or caregiver survive
the day but failing to practice correct handwashing techniques shouldn’t be one of them. All caregivers must remember the necessity of washing their hands.
Remember: Handwashing is the best way to protect you and those around you from infection. With that in mind let’s dive into the proper handwashing technique so that you can keep yourself, your colleagues and your patients safe from risk of infection.
PROPER HANDWASHING PROCEDURES:
1. Soap. Use bar soap, liquid soap, or soap-filled wipes. Keep bar soap in a holder with drain holes. If bar soap sits in a pool of soapy water, it is considered dirty. The soap holder should be cleaned before each new bar of soap is placed in it. If you are using liquid soap or a detergent, the container should be used until it is empty and cleaned before it is refilled.
2. Paper towels. Paper is preferable but clean cloth towels can be used if they are not shared with others.
3. Warm running water. A basin or sink of standing water will not allow for proper cleansing as the pathogens may not be washed away.
4. Nail brush
5. Trash container
WHEN SHOULD YOU WASH YOUR HANDS?
As a caregiver, you need to know when and how often you should wash your hands. Whether or not handwashing should occur depends on several factors, such as:
• The type of activity. Does it involve touching soiled items or pathogens? For example, are you giving a bed bath or helping a person with toileting?
• The intensity of the activity. Is there a high degree of contact with soiled items or pathogens? For example, are you cleaning someone who has lost bowel control, or who is vomiting or bleeding?
• The length of the activity. Will there be contact with the person and pathogens over a long period of time?
• The series of activities. In what order are you carrying out your tasks? For example, are you changing a soiled bed before you serve someone a meal?
Steps in good handwashing
1. Keep your fingernails short. If your nails are not short, they should be trimmed. Long nails can carry a number of pathogens that become trapped underneath and may not be washed away even with proper handwashing. Artificial (fake) nails should not be worn since it has been proven that they carry more pathogens than natural nails.
2. Remove jewellery from your hands and arms. This is necessary as microorganisms can grow in the grooves of jewellery and spread to people or objects. A wristwatch with an elastic band may be worn and moved up to the elbow before washing begins. The watch can also be pinned to your clothes.
3. Check your hands for breaks in the skin. These can include sores, cuts, or hangnails. You may have to wear gloves to avoid contact with infected substances.
4. Stand directly in front of the sink. Your waist should be below the level of the sink. You may have to bend your knees if you are above this level. Do not lean against the sink or get your uniform wet since microorganisms are attracted to moist places.
5. Use a paper towel to turn on the water. This will ensure that you do not pick up pathogens from the faucet.
6. Adjust the water so that it is warm. Cold water does not produce enough lather from the soap to remove pathogens. Hot water can have a drying effect and be irritating to the skin.
7. Wet your hands and hold your arms under the running water. Hold your hands lower than your arms so the water runs from your arms to your hands and fingers into the sink. This prevents pathogens from the hands from getting washed onto the arms. Note: You should always wash from the cleanest area to the dirtiest area.
8. Apply soap to your hands. About a teaspoon or 5 ml. is required if you are using liquid soap. If you are using a bar soap, rub it firmly between your hands two or three times before you begin to lather it. Once soap has been applied, wash your hands and fingers. Use plenty of lather and friction for 10 to 15 seconds. Make sure to wash all surfaces of the hand (palm, back, fingers, wrist). Always clean between the fingers as these areas are often neglected and pathogens grow easily there. If your hands are heavily soiled, you may have to wash for longer than 15 seconds.
9. Make sure lather gets under your nails as well. Use a nailbrush to scrub under the nails. Add water to the soap so that it does not dry out while you are rubbing.
10. Rinse your hands with warm running water. Again, hold your arms downward toward the sink so the water can flow down your arms, over your hands and into the sink.
11. Use paper towels to dry your hands and arms. Place them in a garbage or trash container.
12 Turn off the water using a paper towel to hold the faucet. This ensures that you do not pick up pathogens from the faucet on your hands.
Part of your role as a caregiver is to think about these factors when deciding when you should wash your hands. It has been recommended that caregivers wash their hands:
• When they are obviously soiled
• Before and after contact with the person in their care
• Following contact with a source of microorganisms such as blood, mucus, a broken skin area, or an object that could be contaminated
• Before performing tasks such as giving needles, packing open wounds, or inserting catheters (You may not be required to perform such tasks in your job)
• After removing glove
• Use a standing basin of water to wash and rinse your hands. Running water is needed to wash away microorganisms from your hands.
• Use a common towel for you and others. Instead, use paper towels if possible. If not, use a separate clean towel for each person.
• Wear long or artificial (fake) nails when caring for someone. They promote the growth of pathogens.
• Wear a lot of jewellery because pathogens can grow well on them.
• Use a hand lotion (moisturizer) to prevent your hands from becoming dry and cracked. Dry, cracked or broken skin on the hands can make it easier for pathogens to enter and cause infections.
• Follow the rules of infection control. It is important to know when you should wash your hands and how to wash them correctly.
• Teach the people in your care and their families how and when to wash their hands.