Hand hygiene is crucial for infection prevention and is defined as methods for cleaning hands, including the use of soap or alcohol-based rubs. The WHO outlines five key moments for hand hygiene in healthcare settings, emphasizing proper practices before and after patient contact, procedures, and exposure to bodily fluids. Types of hand hygiene include routine washing, antiseptic hand hygiene, and surgical hand scrubs, each with specific procedures to reduce microbial presence effectively.

1. HAND HYGIENE
BY: MS. RINKAL PATEL

2. INTRODUCTION
 Hand hygiene or hand washing is one
of the most important to prevent the
transmission of infections.
 This is considered as the important
step in the infection control.

3. DEFINITION
 Hand hygiene can be defined as many
method of cleaning the hand that may
include, washing of the hands using
either antimicrobial or nonanimicrobial
soap solutation/water and soap, or
using an alcohol-based hand
rub(liquid, gel or foam) on the surface
of the hands. Accurate hand hygiene
reduces the quality of microbes on
hands.

4. INDICATIONS OF HAND
WASING
 Perform hand washing with soap and
water. It should be done when hands are:
1. Visible soiled or contaminated with
blood or body fluids.
2. After using washroom.
3. Before & after having foods.

5. Common Agents Used for Hand
Washings
 Plain soap or nonmedicated soap
 Alcohols (60-95% ethanol, isopopanol or
n-propanol or combination of these)
 Chlorhexidine
 Chloroxylenol
 Hexachlorophene

6. The choice for hand hygiene product
depends upon the :
 Transmission & patient risk factors:
 The degree of hand contamination.
 The degree to which reduced bacterial
burden is required according to activity.

7. Transmission & patient risk factors:
Practice patient care.
Risk patient care.
Confirmed or suspected resistant
organism.
Invasive or surgical procedures.

8. MOMENTS OF HAND WASING
 The moments of hand hygiene include the
5 moments in particular for the acute
setting & other health setting.
 The ‘5 moments for hand hygiene’
approach is developed by the World
Health Organization(WHO, 2009)

9. First moment : before touching a
patient
 To protect the patient against
acquiring infectious agent from the
hands of the healthcare worker.

10. Second moment: before
performing clean or aseptic
procedure
 To protect patients from infectious
agent (including their own) entering
their bodies during procedures.

11. Third moment: after a procedure
or body fluid exposure risk
 To protect the healthcare workers and
the healthcare surrounding from
acquiring patients’ infectious agents.

12. Fourth moment: after touching a
patient
 To protect the healthcare workers and
the healthcare surroundings from
acquiring patients’ infectious agents.

13. Fifth moment: after touching a
patient surrounding
 To protect the healthcare workers and
the healthcare surroundings from
acquiring patient’s infectious agents.

14. TYPES OF HAND WASHING
Types of
hand
washing
Antiseptic
hand hygiene
Surgical
hand
washing
Routine/medical
hand washing

15. ANTISEPTIC HAND HYGIENE
 This is done using an antimicrobial agent that
is most commonly used while performing
certain procedures on the patients in IPDs,
OPDs or in the isolation wards.
 This type of hand hygiene kills maximum
transient microbial flora of the hands.
 The antiseptic hand hygiene is done during
outbreaks of infection especially when
contact with infected blood or body fluids or
microbial contamination is suspected, during
high risk of involvement work areas, some
invasive procedure being done and during
wound care, catheterization, etc.

16.  The process of antiseptic hand hygiene can be
categorized into the following 2 types based upon
the usage of water during the hygiene process:
1. Antiseptic hand wash: this is the washing of
the hands done by using the antimicrobial soap/
solution & water. The antimicrobial soaps
include, for ex: chlorexidine, iodine etc.
2. Alcohol-based hand rub (ABHR): This
includes the us eof alcohol based antiseptic
hand rub, ex: hydrex hand rub. The use of
ABHR has many advantages for the hand
hygiene purpose.

17. Steps of Alcohol-Based Hand
Rub (ABHR)
Duration of the entire procedure: 20-30
second.
Step 1: Apply alcohol based hand rub
product in a cupped hand, covering all
surface.
Step 2: Rub hands palm to palm.
Step 3: Right palm over left
dorsum with interlaced fingers
and vice versa.

18. Step 4: palm to palm with fingers
interlaced.
Step 5: Back of fingers to opposing
palms with fingers interlocked.
Step 6: rotational rubbing of left
thumb clasped in right palm and vice
versa.
Step 7: rotational rubbing, back wards and
forward with clasped fingers of right hand in
left palm and vice versa. Both wrists in
rotating manner. Once dry, hand are safe.

19. MEDICAL HAND WASHING
 The hands when washed with soap and water
usually remove dirt, dead skin, organic
matter and most of the transient microbes on
the hands.
 The hand washing before general procedures
is called as the routine hand washing.
 The hand washing should be done for at least
40-60 sec.
 Wet the hands and apply soap, rub all
surface, rinse the hands and then dry
thoroughly with a single use towel or tissue
paper.

20. Procedure For Medical Hand
Washing
Collect the articles (soap, towel,
water supply). Do not allow
yourself to touch the washing
area.
For smooth functioning
To prevent contamination of
dree, as sink is considered
contaminated
Remove the ornaments or
jewellery, nails should be short
Microorganisms may collect in
the jewellery and nails.
Turn on the tap & wet your
hands with water, regulate the
temperature.
For easy application of soap &
temperature regulation to
prevent burns. Warm water
opens pores.

21. Take soap from the soap
dispensary, if soap bar is used,
after application rinse it under
water.
Apply soap with firm circular
motion, in such manner that all
hand surface should be covered.
Rinsing soap help to remove the
microorganisms from the
surface
To wash off microorganisms.
The next step is rubbing your
hands palm to palm.
To wash off microorganisms.
Place right palm over left
dorsum with finger interlaced
&vice versa. Rub palm to palm
with finger interlaced.

22. Then rub back of fingers to
opposing palms with fingers
interlocked. Clean the knuckles
thoroughly .
Do rotational rubbing of the left
thumb clasped in right palm and
vice versa.
Paying attention to area that are
commonly missed & microbes
grow.
Perform rotational rubbing in
backward & forwards manners
using clasped fingers of right
hand in left palm & vice versa.
Thereafter working on the wrist.

23. Rinse hands thoroughly with
water & hold the hands down.
To remove soap & dirt
Afterwards dry your hands
thoroughly with a single use
towel or tissue.
So that the hand do not get
contaminated with used towel.
Turn off the tap or faucet by
using tissue paper or towel.
To save water.

25. SURGICAL HAND WASHING
 The hand scrubbing done before a surgical
procedure is called as the surgical hand scrub.
 The purpose of surgical hand hygiene is to
prevent the transmission of microbes from the
hands of the surgical team personnel to the
patient’s wounds.
 The surgical hand scrub removes the soil,
debris, dirt, transient and resident microbes
before and during the surgery.
 Recommended time for washing the hands in 2-
6 minutes.
 The surgical hand scrubbing with antiseptic
agent before beginning surgical procedures:

26.  Minimizes the number of
microorganisms.
 Helps prevent the growth of
microorganism on hand, under the
gloves, for a period of time.
 It reduces the risk infections to the if
the gloves are torn during the
procedure.

27. Steps of Surgical Hand Washing
Steps Rational
Initial three steps are same as medical
hand washing.
Use foot control to dispense a few
droops of the antimicrobial soap or
detergent in to the palm of the hands.
Or
Take appropriately 5mL of hand rub in
the palm of the left hand right hand to
operate the dispenser.
To prevent the
contamination.

28. perform hand washing following the
same steps of hand washing.
Palm to palm, dorsum of hand with
interlocking the webs, knuckles, thumbs,
finger nails, wrist.
Disposable article
prevents cross infection.
Smear the soap on the forearm up to the
elbow (till 1 inch above elbow). Ensure
that the whole skin are until the soap has
fully lathered.
Divided the arm in three parts & work in
circular motion so that the whole arm
surface is cleaned thoroughly. After
cleaning the nail beds dispose the
disposable nail cleaner.
So that all the areas are
paid attention and no
microorganisms are
harbored.
Repeat this procedure in the other arm.

29. Rinse hands and arms under running
water starting at the fingertips and
working toward the elbows
Maintain aseptic technique during the
surgical scrub.
Keep hands upright and elbows down
when rinsing.
Allow water to drip off elbows down
when rinsing.
Dry hands thoroughly prior to donning
gloves, using a sterile towel.