Hand hygiene: What you should (and may not) know

Hand hygiene is the single most important measure for reducing the spread of infection. Cleaning your hands reduces the transmission of potentially deadly germs to patients and reduces the risk of health care provider colonization or infection caused by germs acquired from the patient.  

Did you know? A systematic review in 2022 with 35 articles found that higher compliance with hand hygiene was associated with lower rates of hospital associated infections. 

How is UI Health Care performing?  
Our institutional compliance goal for hand hygiene is set at >90%. However, in March 2023, only 6 out of 30 inpatient units were able to achieve this goal. If you’re curious about how well your unit is performing, you can access the hand hygiene data on Tableau.  

(Hand Hygiene: Hand Hygiene Dashboard – Last Month – Tableau Server (uiowa.edu)) 

UI Health Care will transition from secret-shopper observation approach to a transparent, peer-to-peer observation and stop-the-line approach 
UI Health Care will be participating in the Leapfrog Hospital Safety Grade survey in June. (https://www.leapfroggroup.org/sites/default/files/Files/2022%20Hospital%20Survey_20220608_v8.3%20%28version%202%29.pdf.) The Leapfrog Group is an independent organization that conducts an annual survey of hospitals in the United States to assess their performance in key areas related to patient safety, quality of care, and efficiency.  

As part of their assessment of hospital safety and quality, they include a measure of hand hygiene. To meet the Leapfrog standard, each inpatient unit is required to have at least 200 hand hygiene observations per month, which will be observed and documented by nurses and physicians.  

How to submit a hand hygiene observation 
It’s easier to play your part in documenting hand hygiene compliance when you see it. Simply complete the RedCap survey linked here.  (Hand Hygiene Survey (uiowa.edu)

Take a moment for hand hygiene 
Health care workers may need to clean their hands as many as 100 times during a shift. Keeping hands clean and healthy is a challenge that requires all everyone—no matter your role—to be knowledgeable on when to clean their hands as well as how to clean them effectively.   

Did you know? The “5 Moments for Hand Hygiene” approach was designed by the World Health Organization to minimize the risk of transmission of microorganisms between a health care worker, the patient, and the environment. Five moments you should pause and clean your hands are:  

  • Before touching a patient 
  • Before clean/aseptic procedures 
  • After body fluid exposure/risk 
  • After touching a patient 
  • After touching patient surroundings  

The U.S. Centers for Disease Control and Prevention (CDC) also recommends hand hygiene: 

  • Before moving from work on a soiled body site to a clean body site on the same patient 
  • Immediately after removing gloves 

Most hospitals and clinics emphasize hand hygiene at the time of room entry and exit and prior to any procedure. 

Alcohol-based hand sanitizer vs soap and water: Does it make a difference? 
Alcohol-based hand sanitizer has several advantages over soap and water hand washing in health care settings. It is faster, more convenient, and sanitizers are the most effective products for reducing the number of germs on the hands of health care providers. This makes it easier to perform hand hygiene frequently and consistently, which is essential to reducing the risk of health care-associated infections.  

Hand washing with soap and water is recommended in situations where hands are visibly soiled or contaminated with body fluids, such as after using the bathroom, or handling bodily fluids.  

Fingernails and artificial nails: Is the glam worth the grime? 
Health care worders who wear artificial nails, nail enhancements, or have very long natural nails are more likely to harbor gram-negative bacteria and yeast both before and after handwashing. The CDC recommends that natural nail tips should be kept short and clean.   

Message from the Program of Hospital Epidemiology 
Looking for a way to keep your patients safe and healthy? It all starts with your hands! You have the power to prevent the spread of infection and illness simply by practicing good hand hygiene. By prioritizing hand hygiene, you’re not only protecting your patients—you’re also protecting yourself and your colleagues. So don’t wait; make hand hygiene a top priority today! 

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