2 - Hand Hygiene

The most important thing you can do to prevent the spread of infection in a care home is to keep your hands clean. This is called hand hygiene.

Photo showing hands underneath a tap with running waterHand hygiene is essential to reduce the transmission of infection in care home settings. All staff and visitors should clean their hands with soap and water or, where this is unavailable, alcohol-based hand rub (ABHR) when entering and leaving the care home and when entering and leaving areas where care is being delivered.

 

 

What you need for hand hygiene

  • Liquid soap
  • Running water
  • Alcohol based hand rub (also known as ABHR)
  • Disposable paper towels

When hand hygiene should be performed

before touching a resident;

before clean/aseptic procedures. If ABHR cannot be used, then antimicrobial liquid soap should be used;

after body fluid exposure risk;

after touching a resident;

after touching a resident’s immediate surroundings;

before handling medication;

before preparing/serving food;

after visiting the toilet;

before putting on and after removing PPE;

between carrying out different care activities on the same resident;

after cleaning care equipment;

after disposing of individual’s personal waste;

after handling dirty linen.

It is important that residents are routinely encouraged to perform hand hygiene and given assistance if required.

The four moments for hand hygiene poster can be used in your care home to show staff when hand hygiene should be done and the reasons why.

Select image for full size version.

Before carrying out hand hygiene make sure:

your arms are bare below the elbow;

you take off all your hand and wrist jewellery (a single, plain metal finger ring is allowed but should be taken off (or moved up) during hand hygiene);

bracelets or bangles which are worn for religious reasons, such as the Kara, can be pushed higher up the arm and secured in place;

your finger nails are clean and short;

you cover all cuts or abrasions with a waterproof dressing;

you do not wear artificial nails or nail varnish/products.

Choose the correct product

Liquid soap and water must be used:

Photo showing hands being washed with soap and waterif your hands look dirty; 

If you are caring for a resident who is being sick or having diarrhoea or has diarrhoeal illness such as norovirus or Clostridioides difficile then you must use soap and water for hand hygiene. 

Do not use ABHR as it will not work in these cases.

 

 Make sure you wet your hands before applying liquid soap.

Use paper towels to turn off taps if the taps are not elbow operated mixer taps.

Elbow operated mixer taps are considered to provide the best temperature and flow for optimum hand hygiene and should be considered for any new build, refurbishment or if they need repaired/changed.

When you have washed your hands  dry them thoroughly using paper towel and  dispose of the paper towel in a foot operated waste bin.

 

To make sure you clean your hands properly with soap and water you must follow the steps in the poster How to hand wash step by step images. This poster can be printed off and displayed throughout the care home to ensure that all staff and visitors are aware of and practice this hand hygiene method when required in the care home.

Select image for full size version

Alcohol based hand rub (ABHR)

Photo of someone using alcohol based hand rubAlcohol based hand rub (ABHR) is a gel, foam or liquid containing one or more types of alcohol that is rubbed into the hands to stop or slow down the growth of microorganisms (germs).

If your hands look clean then you can use ABHR for routine care

 

Do not use ABHR if you are caring for a resident who has sickness or diarrhoeal illnesses such as norovirus or Clostridioides difficileYou must use soap and water as ABHR will not work.

 

To make sure you clean your hands properly with ABHR you must follow the steps in the poster ‘How to hand rub step by step images’. This poster can be printed off and displayed throughout the care home to ensure that all staff and visitors are aware of and practice this hand hygiene method when required in the care home.

Select image for full size version

Skin care:

Use warm/tepid water to reduce the risk of dermatitis. Avoid using hot water.

After hand washing pat hands dry using disposable paper towels. Avoid rubbing which may lead to skin irritation/damage.

Use an emollient hand cream during breaks and when off duty.

Refillable dispensers or communal tubs of hand cream should not be provided or used in the care setting.

Staff with skin problems should seek advice from Occupational Health Department if available or their GP

 

Read the hand hygiene literature reviews to find out more about the evidence base for hand hygiene.