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In the world of health care, hand hygiene has always been a critical component of providing safe care. Staff and physicians routinely practice ‘four moments of hand hygiene’ when interacting with patients to stop germ transmission in its tracks. But with the global COVID-19 pandemic, the clinical practice of hand hygiene has moved beyond health care and become routine in all industries and walks of life.
Understanding the importance and the “how-to” of hand hygiene is more important than ever. To recognize World Hand Hygiene Day (May 5) and increase awareness of best practice, IWK Health interviewed infection control practitioner, Christine Sherren.
Q: The slogan for World Hand Hygiene Day is ‘Seconds save lives — clean your hands!’ Can seconds of hand washing really save lives?
A: Yes, those seconds cleaning your hands really can! Keeping hands clean is one of the most important steps we can take to avoid getting sick and spreading germs to others. When germs get onto our hands and we don’t wash them off, they can be passed from person to person. Using alcohol-based hand rub only takes 20-30 seconds, and using soap and water only takes 40-60 seconds.
Q: If peoples’ hands look clean, why should they care about hand hygiene?
A: Just because our hands look clean doesn’t mean they are! Hand hygiene is one of the most effective actions you can take to reduce the spread of germs and prevent infections, including the COVID-19 virus. You can’t see the germs on your hands that you may have picked up throughout your day, and this is why cleaning our hands regularly, even when they look clean, is so important.
Q: When should people wash their hands? What activity should prompt hand hygiene?
A: Everyone should clean their hands before putting on a mask and after removing it, before, during and after preparing food, before and after eating, before and after treating a cut or a wound, after changing diapers of a child, after blowing your nose, coughing or sneezing, or when you have been out doing errands and you return to your car or home, when you have used the washroom, or just whenever your hands are dirty!
Q: When should people use soap to clean their hands and when should they use sanitizer?
A: In a health care setting we use hand sanitizer most of the time, as long as we don’t visibly see something on our hands. Hand sanitizer works well in clinical settings like hospitals, where hands come into contact with germs but are not heavily soiled or greasy. Hand sanitizer is also great during pandemic for those times when you are out and about in your community and don’t have easy access to a sink. If you’re using hand sanitizer, remember to choose one with at least 60 per cent alcohol. If you see something on your hands though, like dirt, or in the health centre if your hands have become contaminated by something visible, it’s recommended to find a sink to clean your hands with soap and water.
Q: What are the IWK’s hand hygiene practices when it comes to patient care?
A: IWK staff follow the ‘4 Moments for Hand Hygiene’ put out by the World Health Organization. This means that we clean our hands 1) whenever we enter a patient care space; 2) whenever we are going to perform a procedure on a patient; 3) after a body fluid exposure risk; and 4) when we leave the care space of a patient. If we all follow these four moments of hand hygiene consistently, we stop germ transmission in its tracks and better protect not only our patients, but also ourselves.
We also conduct hand hygiene auditing each quarter, which gives us a snapshot in time of how well health centre staff are cleaning their hands. Our goal is to achieve greater than 85 per cent compliance as staying above this number significantly impacts germ transmission throughout the hospital, and decreases health care acquired infections.
Q: Does this mean everyone needs to start washing their hands like surgeons?
A: Surgeons entering an operating room do need to clean their hands for a long time to keep their patients safe — but the average person doesn’t need to clean their hands like a surgeon! They do, however, need to remember to clean their hands at key times, like eating, when you get home from being out on errands, after coughing or sneezing, and after using the washroom. The right length of time to clean your hands from start to finish with soap and water is about 30-40 seconds, or the time to sing Happy Birthday twice!
Q: Hand washing has been listed as one of the best ways to combat COVID-19, alongside distancing, masking and isolating when needed. How big of a role do you think it’s played in the COVID-19 response?
A: Keeping our hands clean during the pandemic is one of the simplest, yet most effective, things we can do to protect ourselves. The COVID-19 virus primarily spreads through droplet and contact transmission — droplets happen through coughs and sneezes, and contact transmission means touching infected people and/or contaminated surfaces. Your hands can spread virus to other surfaces and/or to your mouth, nose or eyes if you touch them. The average person touches their face around 23 times an hour, and your eyes, nose and mouth are where germs like to infect your body.
Q: Should people keep up the current, more diligent hand hygiene they adopted as a result of COVID-19 prevention once the pandemic subsides?
A: Absolutely! Everyone has become so much more aware of when we should clean our hands and that has protected us well. Public Health measures like great hand hygiene, and mask wearing, have meant other virus transmission has gone down too, like influenza. We didn’t have an influenza season this year because of all the things everyone has done for the pandemic. Hopefully those good habits established during this time will stay and we will then better protect ourselves in the future from other germs too, not just COVID-19.