Hand hygiene involves cleaning one's hands and is the most effective way to reduce disease transmission. There are various terms used to describe hand hygiene methods including handwashing, antiseptic handwash, and surgical hand antisepsis. Proper hand hygiene techniques should be followed, such as using soap and water for 30 seconds and drying hands thoroughly. Hand hygiene helps prevent infection and avoids disease transmission between individuals.

1. HAND WASH

2. Hand Hygiene and Handwashing
Handwashing is the act of cleaning one’s hands with the use of any liquid with or without soap for the
purpose of removing dirt or microorganisms. It is the most effective measure in reducing the risk of
transmitting infectious diseases.
Terms
To understand this study guide better, familiarize yourself with the terms used:
•Hand Hygiene. It is a general term that applies to handwashing, antiseptic handwash, antiseptic hand rub,
or surgical hand antisepsis
•Hand Washing. It is defined as the washing of hands with plain (i.e., non-antimicrobial) soap and water.
•Antiseptic Handwash. A term that applies to handwashing with an antimicrobial soap and water.
•Surgical Hand Antisepsis. Commonly called as a surgical hand scrub. This is to remove as many
microorganisms from the hands as possible before the sterile procedure.

3. Concepts
Principles and concepts surrounding hand hygiene:
•Use Running water
•You may use soap – antibacterial soap if necessary.
•You must rub your hands against each other for at least 30 seconds
•Keep fingernails short. If you wear a ring, it is better not to remove the ring before hand washing so that it
can be washed too.
•Use disposable paper towels than to use cloth.
•The faucet is recommended to turn it off using a paper towel.
•Dispensers of soap should be used until completely empty.
Purposes
The purposes of hand hygiene are:
•Prevent infection
•Avoid transmission.

4. Types of Hand Hygiene
The following are the types of hand hygiene:
•Routine handwash. Use of water and non-antimicrobial soap for the purpose of removing soil and transient
microorganisms.
•Antiseptic handwash. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and iodophors,
chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying transient microorganisms and
reduce resident flora.
•Antiseptic handrub. Use of alcohol-based handrub.
•Surgical antisepsis. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and iodophors,
chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying transient microorganisms and
reduce resident flora. Recommended duration is 2-6 minutes.
Indicators of Hand Hygiene
According to the World Health Organization (WHO), there are Five Moments for Hand Hygiene:
1.Before Patient Contact.
2.Before and Antiseptic Task.
3.After Body Fluid Exposure Risk.
4.After Patient Contact.
5.After Contact with Patient Surroundings.

6. Supplies Needed
The following materials or equipment are needed to perform hand washing:
•Soap or detergent
•Warm running water
•Paper towels
•Alcohol
•Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

7. When should I wash my
hands with
Soap and Water?
• Soap and water
– It takes approximately three
minutes to wash and dry your
hands effectively.
– Use when the hands are
visibly soiled. The soap and
water will wash away the
contamination.
– Use when in contact with a
patient who has diarrhoea -
alcohol gel won’t work.
– Use if the gel starts to feel
‘sticky’ on your hands.
• Alcohol gel
– Very quick and effective.
– Use between patients.
– Use when entering or leaving
a ward.
– Use after removing gloves
– Doesn’t work against
Clostridium difficile or any of
the diarrhoea causing viruses.
Use soap and water instead.
When should I wash
my hands with
Alcohol Gel?

8. Ability of Hand Hygiene
Agents to Reduce Bacteria
on Hands
0.0
1.0
2.0
3.0 0 60 180
minutes
0.0
90.0
99.0
99.9
log
%
Bacterial
Reduction
Alcohol-based handrub
(70% Isopropanol)
Antimicrobial soap
(4% Chlorhexidine)
Plain soap
Time After Disinfection
Baseline

9. When
washing
hands with
soap and
water
use this
technique

11. Handwashing - Techniques
• Always wet your hands before
you put soap on – it will help to
stop them getting dry
• Make sure you dry them
properly so they don’t get
chapped
• These are the areas of the
hands that people usually miss

12. Alcohol Gel
• This kills 99.8% of bugs living
on your hands
• The gel contains hand
moisturisers to keep your
hands in good condition –
therefore using alcohol gel is
much kinder to the hands than
soap and water
• Alcohol gel should only be used
on visibly clean hands. So if
your hands look visibly dirty –
wash them.

13. Use this technique to clean your hands when using alcohol gel
Squirt once or
twice into the palm
of your left hand
Dip your right hand fingers
into the gel making contact
with your left palm
Transfer the
remaining gel into
your right palm
Dip your left hand fingers
into the gel making contact
with the right palm
Then rub the remaining gel all over your hands,
make sure you rub the backs of your hands too.
1 2 3
4 5 6

15. • We base our audit tool on the World
Health Organisations’ (WHO)
recommendations of when hospital staff
should wash their hands:
Our staff should clean their hands:
1. Before patient contact
2. Before an aseptic task
3. After body fluid exposure
4. After patient contact
5. After contact with the patient surroundings
We conduct unannounced hand hygiene
audits every month in all areas where patients are cared for. The audits last
20 minutes and are conducted by an army of trained auditors (more than 100).
who are nurses, physios, radiologists and other healthcare staff. They feedback the audit results
to the nurse in charge of each area. The results are also presented at key meetings, published in
the Trust News and sent to all executives, general managers and senior nurses and doctors.
HAND WASH AUDIT