Effective hand washing is a key skill all healthcare workers need to be capable of performing. Hands are the main method of pathogen transmission in the healthcare context and therefore hand hygiene is paramount. Your hand washing technique will be assessed regularly both as a student and qualified health professional therefore it’s important you understand how to perform effective hand hygiene. Check out the hand washing OSCE mark scheme here.
When to wash your hands
The “My 5 moments for hand hygiene“ approach describes the key moments when healthcare workers should perform hand hygiene.
The 5 moments of hand hygiene
1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After touching a patient
5. After touching patient surroundings
How to wash your hands with alcohol hand rub
You should clean your hands using an alcohol-based formulation if your hands are NOT visibly soiled.
The entire process of hand washing with alcohol based formulations should take around 20-30 seconds.
The benefits of alcohol-based formulations over soap and water include:
- Faster to clean your hands
- More effective
- Better tolerated by the skin on your hands
Limitations of alcohol-based formulations:
- Not effective if hands are visibly soiled
- Not effective at eradicating spore forming organisms (e.g. C.difficile)
Step by step guide
1. Apply a palmful of the product in a cupped hand, covering all surfaces
2. Rub hands palm to palm
3. Rub your right palm over the dorsum of your left hand, with fingers interlaced, then vice versa
4. Rub your hands together palm to palm with fingers interlaced
5. Rub the backs of your fingers to opposite palms with your fingers interlocked
6. Place your left thumb in your clasped right palm and rotationally rub the thumb, then repeat using your right thumb and clasped left palm
7. Rotationally rub the clasped fingers of your right hand into the left palm and vice versa
8. Allow your hands to dry
How to wash your hands with soap and water
The entire process of handwashing with soap and water should take around 40-60 seconds.
You should always wash your hands (with soap and water) if:
- They are visibly soiled with blood or bodily fluids
- You suspect you have come into contact with spore forming organisms (e.g. C.difficile)
- You have just been to the toilet
Step by step guide
1. Wet hands with water
2. Apply enough soap to cover all hand surfaces
3. Rub hands palm to palm
4.Rub your right palm over the dorsum of your left hand, with fingers interlaced, then vice versa
5. Rub your hands together palm to palm with fingers interlaced
6. Rub the backs of your fingers to the opposite palm with your fingers interlocked then vice versa
7. Place your left thumb in your clasped right palm and rotationally rub the thumb, then repeat using your right thumb and clasped left palm
8. Rotationally rub the clasped fingers of your right hand into the left palm and vice versa
9. Rinse hands with water
10. Dry hands thoroughly with a single use paper towel
11. Use the towel to turn off the tap
1. WHO Guidelines On Hand Hygiene In Health Care. 1st ed. Geneva: World Health Organization, 2009. Available from [LINK].