Updated June 08, 2015.

The World Health Organization and the Centers for Disease Control and Prevention have issued guidelines for proper hand hygiene. Anyone, patients, their families, and staff, with clean, sanitized hands can prevent the spread of germs from one person to another.

Five Moments for Hand Hygiene

The World Health Organization has published 5 key moments to trigger medical staff to remember to clean their hands to help prevent the spread of disease.

1. Before touching a patient

1. Before performing a clean/aseptic procedure
2. Immediately after body fluid exposure risk
3. After touching a patient
4. After touching patient surroundings, even if the patient has not been touched

Advice from the CDC and WHO

The CDC and WHO have published more research on specifically how to evaluate which type of cleansing action one should take. When to...

• SANITIZE
  • Use an alcohol-based hand rub for routinely decontaminating hands when hands are not visibly dirty.
  • Two formulations recommended by the WORLD HEALTH ORGANIZATION for alcohol-based hand rubs: ethanol 80% (v/v) or isopropyl alcohol 75% (v/v).
• CLEANSE
  • Wash hands with plain or antimicrobial soap and water when you can see they are contaminated with blood or other body ï¬?uids.
• CARE
  • It seems like these are easy steps to follow. Why do people still fail to properly clean their hands? The most common reason for hand hygiene failure is that people who must wash their hands as frequently as healthcare workers do, develop chapped hands and other dermatological irritation. When they apply alcohol-based cleansers on top of this, the skin can inflame even more. The pain and irritation therefore causes people to skip cleaning their hands as frequently as they should. Therefore caring for the hands, restoring the moisture and vitamins to the skin throughout the day will prevent the skin irritation. People with healthy, protective skin, will be more compliant with the WHO and CDC hand hygiene recommendations.

Products to Get You Clean

• Instant Hand Sanitizers
  • These are foams, gels, and lotions that sanitize the hands without the need for water.
  • Typically found strategically mounted at the doorway and at the bedside to prompt people to clean when they come in, clean while they are in the room in between touching patient and equipment and supplies, and clean when they leave the room.
• Surgical Scrubs
  • These help prevent infection in the OR where bodily fluids are most prevalent.
  • Staff apply these to scrubs to their hands and forearms because they will be close to the patient's wound or surgical opening. The surgical team uses other protective gear to further prevent healthcare-acquired conditions from occurring through the spread of germs and infections to and from the patient.
  • Surgical scrubs are also used for cleaning the patient's skin around the operation or wound site.
• Plain Soaps
  • Gentle on the skin.
  • Use for removing visible soiling.
  • May be in a pump foam or a pump gel form.
  • May have additives to help nourish the skin such as aloe vera, or Vitamin E
• Antimicrobial/Antibacterial Soaps
  • Kill germs on the skin.
  • Typically contain triclosan to kill bacteria and germs.
  • May also be available with Vitamin E and aloe vera for skin care.
• Lotions
  • Soothe, repair, moisturize, and protect the skin to stand up to frequent washings with soap, alcohol, and triclosan.
  • Available in non-greasy formulations to encourage frequent use
  • Look for ingredients that soothe the skin like colloidal oatmeal, aloe vera, and Vitamin E
  • Consider products with dimethicone and allantonin to help retain moisture
  • Make sure the product you buy for your facility guarantees that it won't interfere with the antimicrobial properties of chemical antiseptics such as chlorhexidine, or damage the integrity of latex glove protection
  • There are lotions on the market now that are so protective, the skin will retain their nourishing properties after several hand-washings
• Shampoo and Body Wash
  • Shampoos and body washes are an economical way to clean all over the body without the need to use multiple types of cleansers for various parts of the body.

Further Resources

• EVIDENCE
  • The World Health Organization's "Evidence For Clean Hands"
  • Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis, The Lancet, Volume 377, Issue 9761, Pages 228 - 241, 15 January 2011.
• TOOLS TO EDUCATE
  • The World Health Organization poster, "How to HandRub"
  • The World Health Organization poster, "How to HandWash"
  • The World Health Organization's "Hand Hygiene: When and How Leaflet"
• MORE ABOUT SKIN REPAIR
  • 9 Skin Care Products for Pressure Ulcer Prevention