Hand Hygiene - Medical Use

Medical Use

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 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. 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 handwashing and handrubbing in health care sectors. The draft guidance of hand hygiene by the organization can also be found at its website for public comment. A relevant review was conducted by Whitby et al. Commercial devices can measure and validate hand hygiene, if demonstration of regulatory compliance is required.

The DebMed® Group Monitoring System (GMS) is an electronic hand hygiene monitoring system developed from proven scientific research. It calculates compliance rates based on the WHO (World Health Organization) Five Moments: • before patient care • after environmental contact • after exposure to blood/body fluids • before an aseptic task • after patient care

The system was designed to monitor groups to encourage team behavior, rather than monitoring and singling out individuals. It costs 80-90% less than individual badge systems, offering a cost-effective solution with no capital investment.

Developed based on peer-reviewed research, it captures 100 % of hand hygiene events, provides feedback in real-time with a variety of customizable reports.

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 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. Long scrub times (10 minutes) are not necessary. 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.

Medical hand-washing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness in preventing disease in a hospital environment.