When should health care workers wash their hands? And other helpful infection prevention measures

At Cynosure Health, we are taking March as an opportunity to do some “Spring Cleaning.” This year it includes sharing information on how to keep our patients and ourselves free from infection. Few things are more important to patient and workforce safety than good hand hygiene.  

In systems as complex as a hospital setting, it’s challenging for health care and ancillary professionals to see the full picture of their role in infection prevention, and how important their personal hand hygiene is to maintaining a safe environment.  As health care leaders, it’s important we convey the appropriate message of just now significant hand washing can be for each individual health care employee. Let’s take a look together at exactly why hand hygiene is so important, when health care workers should wash their hands, and what a sample clinic or hospital hand hygiene policy could look like.  


Why is hand hygiene important in health care? 

When it comes to infection prevention, there’s no greater ally than hand hygiene. Hand hygiene is our number one defense against germs. These germs can spread from patient to patient without even being in contact with each other if the health care professional isn’t adhering to proper hand hygiene guidelines. Ensuring everyone in your organization follows set hand washing policies is critical for the safety of patients, their families, your staff, and the community as a whole. 


When should health care workers wash their hands?

Unanimously and without question, health care workers should wash their hands or use approved hand sanitizing gel or foam upon entering and exiting a patient room. There are other additional times to complete hand hygiene such as after assisting a patient to the bathroom or giving them a bath, providing routine patient care, delivering or picking up meal trays, and other instances your specific clinic or facility should highlight in your hand hygiene policy. Your policy should also specify when hand sanitizing gel or foam may be used, and when soap and water must be used for hand hygiene, such as in the case of caring for patients with infections like C.difficile. 


What to consider when writing a clinic or hospital hand hygiene policy

Specific guidance for hand hygiene practices in a variety of health care settings may be found on the Centers for Disease Control (CDC) website: Hand Hygiene Guidance | Hand Hygiene | CDC. 

Your actual written hand hygiene policy will, of course, be more comprehensive and offer specific guidance for hand hygiene practices with specific populations, such as those with isolation precautions, or in settings such as surgery. 

The policy itself should be easily accessible and present for staff to understand and follow. This can be printouts on bathroom mirrors, copies at the nurses' station or in break rooms, or other places you know employees gather.  


How to enforce good hand hygiene without being forceful

There are a few ways to go about this, but we really recommend you have a peer check of sorts. Find your champion(s) in each shift, in each department, and ask them to help co-design a communication campaign. 

Your champion is someone who peers listen to and respect, who takes an expert-level of care for their patients, wants to help educate others including peers, and pays attention to hospital or clinic policy. Your champion will not be someone who is out to ridicule others or point out flaws, not necessarily someone who is in a leadership role, and is not someone who slacks when it comes to general policy following.  

When you find the person or people that embodies these characteristics, ask them to help identify barriers to proper hand hygiene, as well as ideas to test to address those barriers. Offer a script or some language around how to approach it with their peers.

One example used by some organizations is the use of the phrase “I’ve got your back.” When a supportive team member witnesses another team member forgetting to perform hand hygiene, they use the phrase “Hey I’ve got your back.” The team has been trained to understand this phrase to mean “Hey, we’re all in this together - I know you are busy and it is easy to forget hand hygiene sometimes. It looks like you have forgotten to wash your hands, so I’ve got your back while you take care of that.” It’s a respectful and safe way to hold others accountable when it comes to hand hygiene.


We know that hand hygiene is a vital part of infection prevention, but this isn’t our only defense in preventing unwanted illness and infection in our patients. Are you ready to dig deeper and broaden your understanding of infection prevention tactics? Check out the latest CLIC hub course on Infection Prevention from Lakshmy Menon and Sara Turkel, Infection Preventionists with over 15 years of experience each, ready to give you an accessible approach to IP.