3 improvements to your hand hygiene routine
World Hand Hygiene Day is May 5, and in 2020, it’s more relevant than ever! Hand hygiene is currently emphasized as the most effective way to prevent spread of the novel coronavirus. By now, we are well-versed in correct protocol for this simple procedure (also see my previous post about hygiene protocol). But is there room for improvement? Scrubbing into surgery is second nature to me but I have to admit, when it comes to hand hygiene outside of the operating room, there were a few interesting tips I picked up during my daily COVID-19 binge reads. Here’s three things I’ve learned about hand hygiene:
When using hand sanitizer, don’t forget your fingertips and backs of your hands.
Seems like common sense, but I was neglecting these crucial areas! The whole process should take you 20-30 seconds, and be generous with the amount you use. This is the entire step-by-step waterless handrub procedure as recommended by the World Health Organization:
1. Apply a palmful of an alcohol-based hand sanitizer in your cupped hand
2. Rub your hands together palm to palm
3. Rub right palm over the back of your left hand, interlacing fingers, then switch hands
4. Rub your palms together with fingers interlaced
5. Backs of fingers to opposing palms with fingers interlocked
6. Rotate each thumb in your opposite clasped palm, then switch
7. Rub the tips of your fingers in the opposite palm then switch
8. Let them dry completely!
DIY hand sanitizer isn’t a great idea.
I’m starting to see toilet paper and bottled water back on grocery store shelves, but hand sanitizer still seems to be scarce. Due to these shortages, do-it-yourself alcohol-based hand sanitizer recipes are popping up everywhere online. But it’s not as easy as throwing together some rubbing alcohol and aloe vera gel. The precision and sterility required may not be realistic for at-home preparations. Sanitizer formulations require at least 60% ethanol in order to inactivate viruses. Too little, and it’s ineffective; too much, and it becomes very drying and irritating to the skin. While we’re waiting for stores to replenish their stock (I’ve had some luck at office supply retailers), good old-fashioned hand washing with soap and water is an alternative.
Be sure to moisturize after!
Irritant contact dermatitis is extremely prevalent in healthcare workers, with symptoms ranging from dryness and redness to cracks and fissures. Frequent handwashing is most often the culprit, as soap and water depletes the protective lipid barrier of the stratum corneum (top layer of skin). Not only is it uncomfortable, skin excoriation may lead to bacterial colonization and possible spread of viruses as well as other microorganisms. Preventative measures such as using cold or warm water instead of hot water, and patting instead of rubbing hands dry will help. Waterless handrubs, although still drying, are less irritating than soap and water. Hand creams and lotions applied after hand hygiene and at night will help hydrate the skin and replace the depleted lipids. Just make sure to find a gentle, fragrance-free formula.
I hope these tips help upgrade your hand hygiene routine, as it is the single more important step we can take to protect ourselves, our patients, and our loved ones.
Thank you, frontline healthcare workers, for all you do!
Sources: WHO Guidelines on Hand Hygiene in Health Care: A Summary
https://apps.who.int/iris/bitstream/handle/10665/70126/1/WHO_IER_PSP_2009.07_eng.pdf?ua=1
For a step-by-step video, find me on Instagram @DrMonicaKieu