World hand hygiene day: hand hygiene: The simplest way to prevent infections and save lives

Our hands are the home for microorganisms which live on one's skin surface. Mostly, these microorganisms are harmless. But the hands can become infected with germs that are harmful to the body, while nursing the infected individuals at the hospital or home or even by touching the environment of these patients. This may cause infection spread from one individual to another while nursing patients and promote cross transmission of infections and diseases.


Appropriate hand hygiene measures have been shown to decrease the contamination of health care workers' hands and assist in preventing the spread of infection within the hospital thus decreasing the overall health care expense and improvement in the quality of care.


Prevention of most health care associated infections or even other infections in the community can be achieved by doing hand hygiene at the appropriate times.


What diseases do hand hygiene prevent?


Hand hygiene reduces the risk of contracting common respiratory illnesses like cold, influenza (flu), COVID and diarrheal illnesses like typhoid and E.Coli. It also significantly reduces the cross transmission of deadly infections that are multi-drug resistant (MDR) super bugs in the hospital setting including MRSA , VRE, Candida auris etc.



How to perform hand hygiene?


Hand hygiene is done using alcohol-based solution when the hands are not visibly dirty, and with soap and water when the hands are visibly dirty.


The steps of hand hygiene (“WHO- 6 steps”)-Fig.1 are,
After applying 2-3 ml of hand rub solution (alcohol based)
1. Rub both palms together
2. Rub one palm over the back of the other hand and alternate
3. Rub Palm to Palm with fingers interlaced
4. Rub palm over back of fingers, with fingers of both hands interlocked and alternate on both sides
5. Rotate the thumb of one hand by clasping with the other palm and alternate
6. Rub tip of fingers of one hand over the other palm and alternate
Once dry, your hands are safe. The above technique should be done in 20-30 seconds.


When to perform hand hygiene?


WHO advises practicing hand hygiene at the "Five Moments" that are (i) upon patient touch, (ii) before any procedure, (iii) following exposure to body fluids, (iv) following touch with a patient and (v) following touch with a patient's immediate environment. Apart from the above five moments, patients and visitors must wash their hands before food preparation and consumption, before touching eyes, nose or mouth, before and after dressing change of wound or bandages, after using the toilet, after blowing nose, coughing or sneezing. The same can be followed at home as well.


What is the compliance to hand hygiene and what we can do?


Hand hygiene is the basic pillar of an infection prevention program in a hospital. Unfortunately, the available evidence shows that compliance level to hand hygiene is suboptimal in the current healthcare system with an average of 59.6% in intensive care and there exists an extreme difference between high income and low-income countries (65% vs 9.1%)https://www.who.int/teams/integrated-health-services/infection-prevention-control/hand-hygiene).. It is high time for health-care administrators and health care workers to ensure conditions that are conducive to promoting hand-hand hygiene programs and create awareness for patient safety and to improve quality of health care.


10 Reasons Why washing your hands is important:


1. Prevents illnesses (cold, flu, COVID, diarrhea, salmonella)
2. Protects you and your loved ones
3. Helps cross transmission of infections in a hospital setting
4. Prevents hospital acquired infections
5. Reduces the economic burden of additional costs related to hospital acquired infection
6. Help in reducing antimicrobial resistance
7. Improve the quality of health care
8. Improves patient safety
9. Creates a safe working environment
10. Build trust in the hospital and the health care worker


“Practice Hand Hygiene, Save Lives and be a HERO!”

(By Dr. Surendran R, Consultant, Infectious Diseases & Hospital Infection Control , SIMS Hospital)