Hand hygiene is an important measure for preventing cross-transmission of micro-organisms. Embedded deep and impossible to completely eradicate, they are frequently associated with cross-infection (The Department of Health).
According to Holland (2003) the hands are a key source of transport, especially when coming into contact with body fluids, dressings and medical or nursing equipment. Bacteria resident on the hands as well as transient bacteria have been identified as potential sources of HAI’s (Hospital acquired infections).
The consequence of such an infection prolongs patients stay in hospital and adds to the financial cost of care. The techniques and procedures used in hand-washing have been studied over time to find the correct, most effective method. Consequently, this has led to guidelines being established by The Department of Health (2001).
Department of Health Hand-Washing Guidelines
Guidelines ensure all the hand is washed; emphasizing areas that may be missed and the need to ensure hands are thoroughly dried after the procedure. Damp or wet hands can provide an environment for additional bacteria to grow. Recommendations are that hand-washing should be performed upon arrival at work, before approaching and examining each patient, again after examining and caring for patients and hands should be washed before leaving the workplace. Healthcare workers have a responsibility to ensure they follow guidelines set within the procedure to ensure the safety of their patients (NMC).
Procedure for Effective Hand-washing
There are various solutions that can be used to clean the hands, which one is selected will be dependent upon the individual situation and the level of decontamination necessary. Additionally, each department will have particular policies and procedures to adhere to, depending on the kind of patients being cared for. Basic hand-washing is usually performed with an un-medicated detergent following these steps and repeating for the opposite hand each time:
1. Ensure you have a running supply of hot water.
2. Thoroughly wet hands and apply detergent.
3. Rub your hands together to get plenty of lather on your hands.
4. With your palms facing and fingers interlocked move hands up and down to focus on the between finger areas.
5. Rub your thumb with the opposite hand completely enfolding it.
6. Using your index, middle and ring finger, rub the opposite palm in a circular motion.
7. Rub around your wrist with a twisting action.
8. Place your hand palm side down onto the back of your other hand, interlock fingers and rub up and down.
9. With your hand in a loose fist shape, rub your fingertips and nail area against the palm of your other hand.
10.Rinse hands thoroughly and dry with clean paper towels.
11.If appropriate apply alcohol gel to your hands (check with local area policies)
Nurses should ensure that their nails are carefully manicured and that varnish is absent. It is without a doubt that the seemingly simple gesture of hand-washing is essential in the role of infection control and it is an essential skill for student nurses to become familiar with.