UCLA Infection Control Manual

Dr. Andy Wong

California Continuing Education Credits: 6 units

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CHAPTER THREE
HAND WASHING

INTRODUCTION

Hand washing is one of the most important procedures in preventing the transfer of micro-organisms from one person to another. The skin harbors two types of flora, transient and resident. Transient bacteria do not survive and multiply on the skin and are easily removed because they are not firmly attached. Resident organisms can survive and multiply on the skin and are usually of low virulence and are not easily removed.


I. HAND WASHING AGENTS

A. Iodophor:

  1. Effective against all gram-negative and gram-positive bacteria and viruses.
  2. Does not have a long-acting germicidal action.
  3. If used frequently, may cause severe drying of the skin.

B. 4%Chlorhexidine Gluconate; 3% PCMX:

  1. Effective in reducing resident and transient flora.
  2. Sustained antimicrobial effect.
  3. Does not affect the skin adversely.
  4. Approved as a surgical scrub.

C. Antimicrobial hand-cleansing agents

  1. Economical
  2. Mild but effective for general cleansing

II. HAND WASHING EQUIPMENT AND SOAP DISPENSERS

A. Sinks should have electronic, elbow, foot, or knee-action faucet controls.

B. Non-hand-actuated soap dispenser controls are preferable. Empty, disassemble, and clean all refillable hand-cleansing agent dispensers on a regular basis. Do not use bar soaps.


III. HAND WASHING GUIDELINES

Hands should be washed:

  1. For two consecutive 15 second periods at the beginning of each day.

  2. Between patients, before and after going to lunch, taking a break or using the bathroom, or any time they become contaminated.

  3. Before gloving, after de-gloving, and before re-gloving.

  4. At the end of the day.


IV. HAND WASHING TECHNIQUE

Staff involved in patient care must:

A. Remove all jewelry and other ornaments from the hands and wrists.

B. Long or false fingernails increase the risk of puncturing gloves, and thus should be avoided.

C. Technique:

  1. Wet hands under warm running water. Apply amount of soap to work up lather. Vigorously rub hands together, entwining the fingers. Clean under fingernails using the fingernails of the opposite hand. Continue for 15 seconds scrubbing the wrists and lower forearms. Rinse with cool water. Perform second 15 second wash. Rinse soap off under cool, running water. If sides of the sink are touched, repeat hand washing. Dry hands with paper towels.

  2. For invasive procedures, surgical teams must scrub their hands up past the elbows to mid-biceps area for 5 minutes and use a sterile towel to dry hands and arms.

  3. Anti-microbial soap shall be used to wash hands for surgical procedures.

[ CHAPTER 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 ] [ Table of Contents | Appendix | References ]
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