Handwashing is the single most important factor in preventing hospital acquired infections. You should know the reccomentdations that the CDC has made for professionals and handwashing. If you or a loved one are hospitalized and see staff bypassing the recomended recomendations, insist that they follow correct protocols. If they refuse, contact their supervisor.
1. Handwashing Indications
a. In the absence of a true emergency, personnel should always wash their hands.
1) before performing invasive procedures;
2) before taking care of particularly susceptible patients, such as those who are severely immunocompromised and newborns;
3) before and after touching wounds, whether surgical, traumatic, or associated with an invasive device;
4) after situations during which microbial contamination of hands is likely to occur, especially those involving contact with mucous membranes, blood or body fluids, secretions, or excretions;
5) after touching inanimate sources that are likely to be contaminated with virulent or epidemiologically important microorganisms; these sources include urine-measuring devices or secretion collection apparatuses;
6) after taking care of an infected patient or one who is likely to be colonized with microorganisms of special clinical or epidemiologic significance, for example, multiply-resistant bacteria;
7) between contacts with different patients in high risk units.
b. Most routine, brief patient-care activities involving direct patient contact other than that discussed in 1.a. above, e.g., taking a blood pressure, do not require handwashing.
c. Most routine hospital activities involving indirect patient contact, e.g., handing a patient medications, food, or other objects, do not require handwashing.
2. Handwashing Technique
For routine handwashing, a vigorous rubbing together of all surfaces of lathered hands for at least 10 seconds, followed by thorough rinsing under a stream of water, is recommended.
3. Handwashing with Plain Soap
a. Plain soap should be used for handwashing unless otherwise indicated.
b. If bar soap is used, it should be kept on racks that allow drainage of water.
c. If liquid soap is used, the dispenser should be replaced or cleaned and filled with fresh product when empty; liquids should not be added to a partially full dispenser.
4. Handwashing with Antimicrobial-Containing Products (Health-Care Personnel Handwashes)
a. Antimicrobial handwashing products should be used for handwashing before personnel care for newborns and when otherwise indicated during their care, between patients in high-risk units, and before personnel take care of severely immunocompromised patients. Category III (Hospitals may choose from products in the product category defined by the FDA as health-care personnel handwashes. Persons responsible for selecting commercially marketed antimicrobial health-care personnel handwashes can obtain information about categorization of products from the Center for Drugs and Biologics, Division of OTC Drug Evaluation, FDA 5600 Fishers Lane, Rockville, MD 20857. In addition, information published in the scientific literature, presented at scientific meetings, documented by manufacturers, and obtained from other sources deemed important may be considered.)
b. Antimicrobial-containing products that do not require water for use, such as foams or rinses, can be used in areas where no sinks are available.
5. Handwashing Facilities
a. Handwashing facilities should be conveniently located throughout the hospital.
b. A sink should be located in or just outside every patient room. More than one sink per room may be necessary if a large room is used for several patients.
c. Handwashing facilities should be located in or adjacent to rooms where diagnostic or invasive procedures that require handwashing are performed (e.g., cardiac catheterization, bronchoscopy, sigmoidoscopy, etc.).
