Hand Hygiene     –   an act of cleaning hands

• The importance of hand washing for human health – particularly for people in vulnerable circumstances like mothers who had just given birth or wounded soldiers in hospitals – was first recognized in the mid 19th century by two pioneers of hand hygiene: the Hungarian physician Ignaz Semmelweis who worked in Vienna, Austria and Florence Nightingale, the English “founder of modern nursing”. At that time most people still believed that infections were caused by foul odors called miasmas.
  Hand hygiene, is the act of cleaning hands for the purpose of removing soil, dirt, and microorganisms. If water and soap is not available, hands can be cleaned with ash instead.
• Medical hand hygiene refers to hygiene practices related to medical procedures. Hand washing before administering medicine or medical care can prevent or minimize the spread of disease. The main medical purpose of washing hands is to cleanse the hands off pathogens (like bacteria or viruses) and chemicals which can cause harm or disease. This is especially important for people who handle food or work in the medical field, but also important practice for the general public.
  Hand-washing with soap consistently at critical moments during the day prevents the spread of diseases like diarrhoea and cholera which are transmitted through –fecal-oral routes. People can become infected with respiratory diseases such as influenza or the common cold, for example, if they do not wash their hands before touching their eyes, nose, or mouth.
  Hand-washing has the following health benefits:
  • helps to minimize the spread of influenza
  • diarrhea prevention
  • avoiding respiratory infections
  • a preventive measure for infant deaths at their home birth deliveries
  • improved hand washing practices have been shown to lead to small improvements in the length
  • growth in children under five years of age
• Hand-washing also protects against impetigo which is transmitted through direct physical contact.
  Medical hand-washing is for a minimum of 15 seconds, using generous amounts of soap and water or gel to lather and rub each part of the hands. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush may be used to remove it. Since germs may remain in the water on the hands, it is important to rinse well and wipe dry with a clean towel. After drying, the paper towel should be used to turn off the water (and open any exit door if necessary). This avoids re-contaminating the hands from those surfaces.
• The purpose of hand-washing in the health-care setting is to remove pathogenic microorganisms (“germs”) and avoid transmitting them. The New England Journal of Medicine reports that a lack of hand-washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients, thus transmitting microorganisms. One study showed that proper hand-washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.
• The World Health Organization has published a sheet demonstrating standard hand-washing and hand-rubbing in health-care sectors. The draft guidance of hand hygiene by the organization can also be found at its website for public comment.  Commercial devices can measure and validate hand hygiene, if demonstration of regulatory compliance is required.
• The World Health Organization has “Five Moments” for washing hands:
  • before patient care
  • after environmental contact
  • after exposure to blood/body fluids
  • before an aseptic task, and
  • after patient care.The addition of antiseptic chemicals to soap (“medicated” or “antimicrobial” soaps) confers killing action to a hand-washing agent. Such killing action may be desired prior to performing surgery or in settings in which antibiotic-resistant organisms are highly prevalent.
• To ‘scrub’ one’s hands for a surgical operation, it is necessary to have a tap that can be turned on and off without touching it with the hands, some chlorhexidine or iodine wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewelry should be removed. This procedure requires washing the hands and forearms up to the elbow, usually 2–6 minutes. When rinsing, water on the forearms must be prevented from running back to the hands. After hand-washing is completed, the hands are dried with a sterile cloth and a surgical gown is donned.

1- Wet your hands and apply enough soap

2 – Rub your palms together.

3 – Rub the back of each hand

4 – Rub both your hands while interlocking your fingers

5 – Rub the back of your fingers

6 – Rub your thumbs and the  ends of your wrists.

7 – Rinse both hands properly with water

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