Top Five Things that Impact Effective Hand Hygiene

Today is World Hand Hygiene Day! To celebrate, we asked one of our hand hygiene content leads to provide some insight into the top five things that impact effective hand hygiene.

Guest post by Debbie Valickis, Regional Infection Control Consultant, Public Health Ontario

One can have the best technique and the best product but there other things that need to be considered to ensure hand hygiene is effective.

1. Jewellery is difficult to clean and will harbor microorganisms. Rings and bracelets should not be worn by healthcare providers in direct contact with a client, patient or resident. Share our fun video Ask Yourself: Is the glam worth the grime with your staff or colleagues to increase their awareness.
2. Artificial nails, nail enhancements and long nails are also difficult to clean.  Long and artificial nails are connected to transmitting microorganisms such as Pseudomonas¹, Klebseilla pneumonia² and yeast in health care settings and are not appropriate for direct client, patient or resident care. Nails should be natural and short. 
3. Finger tips, between fingers, back of hands and base of thumbs are the most commonly missed areas in hand hygiene. Spread product over all surfaces of hands and watch these PHO videos for proper hand hygiene technique: How to Hand Rub and How to Hand Wash.
4. There is a common misconception that antimicrobial soaps are more effective than alcohol-based hand rub (ABHR).  Comparisons of ABHR and antimicrobial soap have shown that they are equal in reducing microorganisms.  ABHR is recommended as antimicrobial soaps are harsher on skin and may result in skin breakdown. Frequent use may also lead to antimicrobial resistance. The PIDAC Best Practices for Hand Hygiene document can be referred to for best evidence and expert opinion on hand hygiene practice
5. The condition of our hands can influence effective hand hygiene.  The presence of dermatitis, cracks or abrasions can trap bacteria and impede hand hygiene.  Dermatitis is reported in approximately 30 per cent of health care workers (HCWs). 

It is important that HCWs:

• moisturize with an approved product compatible with the hand hygiene products
• monitor the skin on their hands
• take action early if their hands become irritated.

More hand care guidance can be found through our JCYH Hand Care Program.

For more information and resources on hand hygiene, please go to Public Health Ontario’s Hand Hygiene webpage. 

References

1. Moolenaar RL, Crutcher JM, San Joaquin VH, Sewell LV, Hutwagner LC, Carson LA, et al. A prolonged outbreak of Pseudomonas aeruginosa in a neonatal intensive care unit: did staff fingernails play a role in disease transmission? Infect Control Hosp Epidemiol. 2000 Feb;21(2):80-5.
2. Gupta A, Della-Latta P, Todd B, San Gabriel P, Haas J, Wu F, et al. Outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit linked to artificial nails. Infect Control Hosp Epidemiol. 2004 Mar;25(3):210-5.