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Hand Hygiene

WRHA Infection Prevention & Control

Learning Booklet

The “who, what,

where, when, how
and why” of Hand
Hygiene
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WHO should be practicing Hand Hygiene?

EVERYONE!

Hand hygiene is important not only for healthcare

providers; everyone needs to be practicing appro-
priate and effective hand hygiene regardless of
work setting

WHAT is Hand Hygiene?

Hand Hygiene includes cleaning hands with soap

and water or alcohol-based hand rub in order to
remove germs, also known as microorganisms
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Hand Hygiene

WHERE should you perform Hand Hygiene?

 Hand hygiene is important in all work settings,
including Acute Care, Long Term Care Facilities,
Community and Corporate sites.
 Busy health care providers need access to hand
hygiene products at point of care where
patient/resident/client (PRC) or PRC
environment contact is taking place.

POINTS OF CARE

The PRC

The Healthcare
Provider

Care involving
contact
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Why do we need to learn about Hand

Hygiene?
 Hand hygiene is the most important way
to prevent the spread of germs.
 Hand Hygiene helps keep you healthy by
reducing the number of germs on your
hands and helps reduce the spread of
germs to your PRC, family, friends, or
coworkers.
 Using appropriate hand hygiene prevents
contamination of the PRC’s environment.

When do you perform Hand Hygiene?

There are FOUR MOMENTS when Hand
Hygiene is performed:
1. BEFORE initial PRC or PRC
environment contact
2. BEFORE aseptic or clean procedure
3. AFTER body fluid exposure risk
4. AFTER PRC or PRC environment contact
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Hand Hygiene

MOMENT 1
BEFORE initial PRC or PRC environment
contact. Some examples are:
Home
environment

Treatment area
or clinic room

This is to protect the PRC and their environment

from harmful germs carried on your hands

MOMENT 2
BEFORE an aseptic or clean procedure examples:

Handling dressings
or touching open
wounds

An aseptic
procedure

Clean your hands immediately before any

aseptic or clean procedure to protect the
patient against harmful organisms
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MOMENT 3
AFTER body fluid exposure examples:

Contact with body fluids,

non-intact skin or mucous
membranes

Removal of
gloves

Using a tissue to wipe

your nose or using the
washroom

Help protect yourself and the

healthcare environment from
harmful patient organisms
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Hand Hygiene

MOMENT 4
AFTER contact with the PRC or the PRC
environment. Some examples are:
Contact with a PRC’s
room or equipment

Shaking
hands

Transferring a PRC

Contact with the home

environment

Contact with
treatment area or
clinic room

Help protect yourself and the healthcare

environment from harmful patient
organisms
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HOW to perform hand hygiene

Proper technique is important when it comes

to effective hand hygiene. Without proper
hand hygiene technique, we can still spread
many microorganisms with our hands. This
section will cover the proper techniques for
the following methods:

Alcohol-based
hand rub
(ABHR)

Soap & water

Without water
when hands are
visibly soiled
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Hand Hygiene

Alcohol Based Hand Rub (ABHR)

The recommended method of hand hygiene
in any healthcare setting when hands are not
visibly soiled

 Apply a dime-sized amount (2-3 ml) of

product into palms of dry hands
 Rub product into hands
 Palm to palm
 Rub fingertips of each
hand in opposite palm
 Between and around
fingers
 Rub each thumb
clasped in opposite
hand
 Rub back of each hand with opposite palm
 Rub hands until dry before performing an-
other task
 DO NOT WIPE OFF
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Alcohol Based Hand

 Alcohol based hand rub (ABHR) is at least

60% ethyl alcohol, or ethanol (equal to 120-
proof). To compare, a bottle of vodka is 80-
proof .

 Ingesting small amounts of ABHR can

produce the same side effects as consuming
large amounts of alcohol:

 Headache, dizziness, drowsiness,

incoordination, nausea, slowed
reaction time, slurred speech,
giddiness, and unconsciousness

 Consumption of ABHR can also result in:

 Brain, liver, and kidney damage (from

long-term use)
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Hand Hygiene

Soap & Water

The recommended method when hands are

visibly soiled. Plain soap is used for routine
hand hygiene while anti-microbial soap is
used in acute care high-risk areas.
 Wet hands under warm running water
 Apply soap and distribute over hands
 Rub hands together vigorously for 15 sec-
onds to create a good lather: Palm to palm
 Rub fingertips of each hand in opposite
palm
 Between and around
fingers
 Rub each thumb
clasped in opposite
hand
 Rub back of each hand with opposite palm
 Rinse hands thoroughly under warm run-
ning water
 Pat hands dry with a paper towel
 Turn off faucet using a paper towel
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Hands Are Soiled and No Water

 Remove visible soiling with moist

towelette
 Apply a dime-sized
amount of hand-rub
product into palms of
dry hands
 Rub product into
hands: Palm to palm
 Rub fingertips of each hand in opposite
palm
 Between and around fingers
 Rub each thumb clasped in opposite hand
 Rub back of each hand with opposite palm
 Rub hands until dry before performing an-
other task
 DO NOT WIPE OFF
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Hand Hygiene

“Handy” Tips

 Artificial nails, gel nails or extenders are not

to be worn by staff who have direct patient
contact.
 Contaminated surfaces or objects should
not be touched after performing hand hy-
giene.
 Avoid touching your face, especially your
eyes and nose.
 Fingernails should be kept short and should
not be seen past the tip of the finger
 Nail polish may be worn, but should be re-
moved when chipped.
 Do not “top up” a partially-used hand hy-
giene product dispenser.
 If re-usable dispensers are used they must
be emptied, washed and dried prior to be-
ing refilled. Hand lotion bottles must not be
re-used.
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 Include frequently missed areas when per-

forming hand hygiene such as thumbs,
palms, web spaces, under nails and the
backs of fingers and hands.
 Use supplied lotions that are compatible
with hand hygiene products and
gloves to minimize skin irritation
that can occur with frequent
hand hygiene.
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Hand Hygiene

Hand Hygiene Quiz

1. Hand hygiene is the most important way

to prevent the spread of germs
(microorganisms).
»True
»False
2. When washing hands, which of the
following is important to remember?
a) Wash with hottest water possible
b) The focus of good hand washing is the
palms
c) Turn faucet off after disposing of your
paper towel
d) Lather and rub hands together for 15
seconds

3. Alcohol-based hand rub may be used

instead of soap and water when hands are
not visibly soiled.
»True
»False
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4. Which of the following is the correct order

when performing hand hygiene?
a) Wet hands; Apply soap; Rub vigorously;
Rinse hands
b) Apply soap; Wet hands; Rub vigorously;
Rinse hands
c) Apply soap; Rub vigorously; Rinse hands;
Turn off faucet
d) Wet hands; Apply alcohol based hand rub;
Rub vigorously; Turn off faucet

5. When hands are visibly soiled and water is

not available, how is hand hygiene
performed?
a) Using a moist towelette
b) Using alcohol based hand rub
c) Using a moist towelette followed by
alcohol-based hand rub
d) Using a disinfectant wipe
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Hand Hygiene

Answer key:
1. TRUE 4. A
2. D 5. C
3. TRUE