10.1 Guidelines for Hand Hygiene in Health-Care Settings

The Centers for Disease Control (CDC), Health Care Infection Control Practice Advisory Committee (HICPAC), Society for Healthcare Epidemiology of America (SHEA), Infectious Disease Society of America (DSA), and Association for Professionals in Infection Control (APIC) have made 2002 Hand Hygiene recommendations for the use of soap and water and alcohol-based rubs in the health care center.¹ Proper hand hygiene can help prevent the spread of antimicrobial-resistant infections, whereas poor hand hygiene may be a contributing factor in patient mortality. Compliance for hand hygiene is noted to be problematic among health care workers.²

Interestingly, the CDC/HICPAC recommendations address rehabilitation-related concerns such as hand hygiene management after lifting patients or touching equipment near patients. Along with guidelines below, additional recommendations for health care workers include keeping nail tips <¼ inch length; not using same gloves on more than one patient; changing gloves when moving from a contaminated to an uncontaminated body site; wearing gloves if contacting blood, mucous membranes, non-intact skin or other infectious material; and not wearing artificial fingernails or extenders if one has direct contact with high-risk patients (e.g., ICU, operating rooms).

SOAP AND WATER

The CDC/HICPAC recommends you wash with soap (non-antimicrobial or antimicrobial) and water under the following circumstances.

Use soap (non-antimicrobial or antimicrobial) and water if:

Procedure: Using Soap and Water

CDC/HICPAC recommends you wash with soap and water in the following manner: (1) Wet hands. (2) Apply amount of soap recommended by manufacturer. (3) Rub hands together vigorously for at least 15 seconds. (4) Rinse hands with water. (5) Dry hands thoroughly with a disposable towel. (6) Use towel to shut off faucet. (7) Avoid hot water (because repeated exposure increases risk of dermatitis). (8) If soap bar is used, drain soap on rack and use small bars. (9) Avoid multiple use of cloth towels (handing type; roll type)—they are not recommended in a health care setting.

ALCOHOL-BASED HAND RUB

The CDC/HICPAC recommends you use alcohol-based hand rubs under the following circumstances.

Use an alcohol-based hand rub if:

Procedure: Using an Alcohol-Based Hand Rub

The CDC/HICPAC recommends the following technique for using alcohol-based hand rubs: (1) Apply the alcohol-based hand rub to one palm. Follow the manufacturer’s recommended volume to use. (2) Rub hands together. (3) Cover all surfaces of your hands and fingers until hands are dry.

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