The information below is about hand hygiene in healthcare settings. Use an alcohol-based hand rub for all clinical situations where hands are visibly clean. Wash with soap and water when hands are visibly dirty or contaminated with proteinaceous material, or visibly soiled with blood or other body fluids, or if exposure to potential spore forming organisms is strongly suspected or proven, or after using the bathroom. Hand hygiene is a general term referring to any action of hand cleansing, which includes: The World Health Organization (WHO) has developed the following posters on performing hand hygiene: Wearing gloves does not replace the need for hand hygiene, as gloves do not provide complete protection against hand contamination. Microorganisms may gain access to the healthcare workers' hands via small defects in gloves, or by contamination of the hands during glove removal. Gloves should be worn: Gloves should be changed: Hand hygiene is required with glove use: Hand hygiene products and gloves should be made available inside isolation/contact precaution rooms to allow for appropriate hand hygiene to occur during the care of a patient. Prolonged and indiscriminate use of gloves should be avoided as it may cause adverse reactions and skin sensitivity. For further information on glove use refer to the Australian Guidelines for the Prevention and Control of Infection in Healthcare. Hand care issuesIntact skin is a first line defence against infection. Damaged skin can not only lead to infection in the host, but can also harbour higher numbers of microorganisms than intact skin and increase the risk of transmission to others. The management of hand care problems associated with the use of hand hygiene products requires early recognition and a systematic approach to ensure success. There are two major types of skin reactions associated with hand hygiene:
The majority of skin problems among healthcare workers that are related to hand hygiene are due to irritant contact dermatitis. Irritant contact dermatitis is primarily due to frequent and repeated use of hand hygiene products; especially soaps, other detergents, and paper towel use, which result in skin drying. The initial use of alcohol-based hand rubs among such healthcare workers often results in a stinging sensation. However, recent studies have suggested that the ongoing use of emollient-containing alcohol-based hand rub leads to improvement in irritant contact dermatitis in approximately 70% of affected healthcare workers. Also, the use of an oil-containing lotion or a barrier cream three times a shift can substantially protect the hands of vulnerable healthcare workers against drying and chemical irritation, preventing skin breakdown. It is important to ensure that the selected alcohol-based hand rub, soaps, and moisturising lotions are chemically compatible to minimise skin reactions among staff. Factors that may contribute to dermatitis include:
Strategies for minimising occupational hand dermatitis include:
Alcohol-based hand rub produces the lowest incidence of irritant contact dermatitis of all the hand hygiene products currently available. True allergy to alcohol-based hand rub is rare, and allergy to alcohol alone has not been reported. Healthcare workers should be encouraged to notify their hand hygiene lead if skin irritation occurs following the use of alcohol-based hand rub. All hospitals should have access to referral for follow up for healthcare workers with persistent skin problems. For example: an occupational dermatologist, local doctor, or emergency department. WHO consensus recommendations on skin care are included in Appendix 6 of the National Hand Hygiene Initiative User Manual. Hand care resources
Medically Reviewed by Dany Paul Baby, MD on April 21, 2022 When you are purchasing soaps for your home, several factors come into play. You may opt to consider cost, color, brand, and other properties. Among these properties, should you consider whether you are purchasing antibacterial soap vs plain soap? Do you feel that one will keep your family safer? To date, the U.S. Food and Drug Administration (FDA) has not found definitive evidence to show that antibacterial soaps are any better than washing with regular soap and water when it comes to preventing illness. However, depending on the setting of your use, there are still several factors to consider. Also known as antiseptic soap or antimicrobial soap, antibacterial soaps contain certain chemicals not included in plain soap. The purpose of adding these chemicals is to reduce or prevent bacterial infection. Water, coupled with plain soap, loosens the grip of almost all surface germs. They have properties that are polar and nonpolar, making bacteria dissolve more easily. This removes pathogens physically from a surface but does not stop their production or kill them. Antibacterial soap, on the other hand, can be processed with a chemical called triclosan or triclocarban. This chemical is not found in plain soap. This ingredient is meant to stop the production of bacteria. The FDA has not yet found evidence that it is better at preventing sickness, though. Antibacterial soaps are marketed as preventing bacterial production and killing pathogens. The chemical additive of antimicrobial soaps, triclosan, can be found in many places. It is added to consumer products like clothing, toys, furniture, and kitchenware to prevent contamination via bacteria. This results in long-term exposure to triclosan. Meanwhile, in 2013, the FDA issued a ruling requiring safety data on antibacterial soaps. After research was completed, the final ruling regarding antiseptic liquids, bar soaps, body washes, foams, and liquids was that they should cease making certain claims in their marketing. This was because the products were not shown to be more effective than plain soap and water at preventing infection, and there was no proven information on the safety of exposure to antibiotic chemicals over a long period. Generally, antibacterial soap: Plain soaps, meanwhile: Some pros of antibiotic soaps are that you can find them in most stores, and they can kill dangerous bacteria. The cons, however, are that they can also kill healthy bacteria on your skin. Their added chemicals can strip natural oils and make your skin dry. Also, the use of antibacterial soap can give a false sense of cleanliness, and people may wash less frequently. Plain soap is recommended for non-healthcare settings in the public and home unless antibacterial soap is recommended by a doctor. Antibacterial soaps are no more effective at killing germs outside of a carefully sterilized healthcare setting. In most cases, thorough handwashing is the determining factor in germ illness prevention. Liquid soap is preferred to bar soap for hand cleaning. It is easier to use and won't typically cause germs to spread from one person to another if soap is shared. Additionally, a moisturizing ingredient is often added to liquid soaps so that frequent hand washing will not dry out your skin. Bar soaps are recommended less often because germs can grow on the surface and be easily transmitted between people. It is okay for use in the household if no one has a skin infection, but public places should not promote the use of bar soap. Some scientists believe that the use of antibacterial soap can lead to the creation of antibiotic-resistant germs. Lab studies have suggested that the chemical triclosan contributes to bacteria that are resistant to antibiotics. This could have a major effect on the future of medical treatments. Additionally, triclosan is an ingredient that concerns many regulatory, academic, and environmental groups. Studies on animals have shown that the way in which hormones work in your body is altered by triclosan. This raises concerns about potential effects on humans. More research is needed. As many as 95% of adults wash their hands incorrectly. The following steps will ensure that your hands are always at their cleanest: A hand sanitizer can cause people to think that they do not have to wash their hands as rigorously or as often. When soap and water are unavailable, the use of a hand sanitizer with 60% alcohol content can indeed be an effective alternative. Sanitizer is a good antimicrobial, but it does not eliminate all germs and is not recommended when hands have visible dirt or grease. The CDC makes the following recommendations for adults and children regarding the use of hand sanitizer: |