Hand washing is the single most important method of preventing the spread of

infectious diseases. By frequently washing your hands, you eliminate up to 99.9 % of germs you may have picked up from contaminated surfaces. Health care professionals tried their best to prevent transmission of germs from one patient to another. Today, there are a lot of methods on how to prevent cross contaminations. This is through hand washing. This procedure is simple and is commonly applied within our household. Hand washing is one of the most important interventions to combat germs. There are different types of hand washing and these are commonly practiced in all health care institutions (hospitals, diagnostic laboratory, and clinics). These are the medical hand washing and the surgical hand washing.
When To Wash Hands ? Wash your hands before: Making food Eating or drinking Giving first aid Caring for someone who is sick

Wash your hands after: Going to the bathroom Changing diapers Cleaning up after someone who has urinated or defecated Giving first aid Caring for someone who is sick Preparing food, especially after touching raw meat, poultry or fish Coughing, sneezing or blowing your nose Handling animals or animal waste Taking out the garbage Handling things that were touched by flood water or sewage

In addition, wash your hands whenever they look dirty.

Substances used Soap and detergents The application of water alone is inefficient for cleaning skin because water is often unable to remove fats, oils, and proteins, which are components of organic soil. However, since pathogens removed from the skin have to be rinsed away, there must be a reasonable flow of water.

Therefore, removal of microorganisms from skin requires the addition of soaps or detergents to water. Currently most products sold as "soaps" are actually detergents, so that is the substance most used to wash hands. Water temperature Hot water that is comfortable for washing hands is not hot enough to kill bacteria. Bacteria grows much faster at body temperature (37 C). However, warm, soapy water is more effective than cold, soapy water at removing the natural oils on your hands which hold soils and bacteria. Contrary to popular belief however, scientific studies have shown that using warm water has no effect on reducing the microbial load on hands Solid soap Solid soap, because of its reusable nature, may hold bacteria acquired from previous uses. Yet, it is unlikely that any bacteria are transferred to users of the soap, as the bacteria are rinsed off with the foam. Antibacterial soap Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. However, antibacterial soaps contain common antibacterial agents such as Triclosan, which has an extensive list of resistant strains of organisms. So, even if antibiotic resistant strains aren't selected for by antibacterial soaps, they might not be as effective as they are marketed to be. Hand antiseptic A hand sanitizer or hand antiseptic is a non-water-based hand hygiene agent. Hand sanitizers are most effective against bacteria and less effective against some viruses. Alcohol-based hand sanitizers are almost entirely ineffective against norovirus or Norwalk type viruses, the most common cause of contagious gastroenteritis. The increasing use of these agents is based on their ease of use and rapid killing activity against micro-organisms, however they should not serve as a replacement for proper hand washing unless soap and water are unavailable.

Techniques Soap and water Conventionally, the use of soap and warm running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean towel, disposable or otherwise. It has been shown that the use of a towel is a necessary part of effective contaminant removal, since the washing action separates the contaminants from the skin but does not completely flush them from the skin - removing the excess water (with the towel) also removes the suspended contaminants. After drying, a dry paper towel should be used to turn off the water (and open the exit door if one is in a restroom). Moisturizing lotion is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day. Hand antiseptics Enough hand antiseptic or alcohol rub must be used to thoroughly wet or cover both hands. The front and back of both hands and between and the ends of all fingers are rubbed for approximately 30 seconds until the liquid, foam or gel is dry.

Drying Effective drying of the hands is an essential part of the hand hygiene process, but there is some debate over the most effective form of drying in washrooms. A growing volume of research suggests paper towels are much more hygienic than the electric hand dryers found in many washrooms.

TYPES OF HAND WASHING Surgical Hand Washing All sterile team members should perform the hand and arm scrub before entering the surgical suite. The basic principle of the scrub is to wash the hands thoroughly, and then to wash from a clean area (the hand) to a less clean area (the arm). A systematic approach to the scrub is an efficient way to ensure proper technique. There are two methods of scrub procedure. One is a numbered stroke method, in which a certain number of brush strokes are designated for each finger, palm, back of hand, and arm. The alternative method is the timed scrub, and each scrub should last from three to five minutes, depending on facility protocol. To 'scrub' one's hands for a surgical operation, it is necessary to have a tap that can be turned on and off without touching with the hands, some chlorhexidineor iodine wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewelry should be removed. This procedure requires washing the hands and forearms up to the elbow, usually 26 minutes. Long scrub times (10 minutes) are not necessary. When rinsing, water on the forearms must be prevented from running back to the hands. After hand washing is completed, the hands are dried with a sterile cloth and a surgical gown is donned. Medical Hand Washing Medical hand washing is for a minimum of 15 seconds using generous amounts of soap and water or gel to lather [23] and rub each part of the hands. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush may be used to remove it. Since germs may remain in the water on the hands it is important to rinse well and wipe dry with a clean towel. After drying, the paper towel should be used to turn off the water (and open any exit door if necessary). This avoids re-contaminating the hands from those surfaces.

iEZ2012