HYGIENE OF THE
HANDS
EHS 203
(Hygiene Education and promotion)
Group Four
TABLE OF CONTENT
■ INTRODUCTION AND SCOPE
■ HISTORICAL CONTEXT AND RATIONALE
■ METHODS OF HAND HYGIENE
■ GUIDELINES AND BEST PRACTICES
■ ENVIRONMENTAL AND SUSTAINABILITY
CONSIDERATIONS
■ CASE STUDIES AND RESEARCH EVIDENCE
■ PRACTICAL DEMONSTRATION
■ CONCLUSION
DEFINITION AND IMPORTANCE OF
HAND HYGIENE
Hand hygiene refers to the practice of
cleaning one’s hands to remove dirt,
microorganisms, and other contaminants.
It is essential in preventing the
transmission of infectious diseases and
maintaining overall public health. Hands
are the primary means of transmitting
pathogens in healthcare settings,
workplaces, schools, and homes.
Proper hand hygiene reduces the spread
of bacteria and viruses, including E. coli,
Salmonella, influenza, and coronaviruses.
A lack of hygiene can contribute to
environmental contamination through
cross-contamination of surfaces and food.
HISTORICAL CONTEXT AND
RATIONALE
Ancient Egypt (around 2500 BCE)
Hinduism and Ayurveda (around 1500 BCE)
■ Greek and Roman civilizations (around 500 BCE – 500 CE)
Key milestones:
1. Ignaz Semmelweis (1847): Introduced hand washing with soap and water as a mandatory practice
for medical staff to reduce puerperal fever.
2. Louis Pasteur (1861): Demonstrated the germ theory of disease, highlighting the importance of
hand hygiene in preventing the spread of infections.
3. Joseph Lister (1865): A British surgeon who implemented antiseptic hand washing with carbolic
acid, significantly reducing post-operative infections.
The rationale behind hand hygiene is simple:
1. Prevention of infection transmission.
2. Reduction of healthcare-associated infections.
3. Protection of vulnerable populations.
METHODS OF HAND HYGIENE
■ General Hand Hygiene
1. Hand washing with soap and water
2. Alcohol-Based Hand Sanitizers
(ABHS)
3. Antiseptic hand wash
4. Antiseptic hand rubs
5. Surgical hand antisepsis
■ Hand Lotion And Skincare
■ Nail Hygiene
GUIDELINES AND BEST
PRACTICES FOR HAND HYGIENE
A. General Hand Hygiene Guidelines
1. Hand Washing With Soap And Water.
■ Use clean, running water (warm or cold).
■ Wet hands first before applying soap.
■ Lather and scrub all hand surfaces, including palms,
back of hands, between fingers, and under nails, for
at least 20 seconds.
■ Rinse thoroughly under running water.
■ Dry hands completely using a clean towel or air dryer.
Best Practices
■ Use liquid soap instead of bar soap in public places to
reduce contamination.
■ Turn off the faucet with a paper towel to avoid
recontamination.
2. Alcohol-Based Hand Sanitizer.
Use a sanitizer with at least 60% alcohol for
effectiveness.
Apply enough sanitizer to cover all hand
surfaces.
Rub hands together until completely dry
(about 20 seconds).
■ Do not rinse or wipe hands after applying
sanitizer, as it reduces effectiveness.
Best Practices
Use when hands are not visibly dirty.
■ Avoid touching surfaces immediately
after application to allow proper
disinfection
3. Antiseptic Hand Wash
Use antimicrobial soap with active ingredients like
chlorhexidine, iodine, or triclosan. 5. Surgical Hand Antisepsis.
■ Follow the same hand washing technique as with Remove all jewellery and ensure nails are
regular soap but extend scrubbing time to 30 seconds. short and clean.
■ Rinse thoroughly and dry with a sterile towel. Use an antimicrobial scrub solution (e.g.,
■ chlorhexidine, povidone-iodine) or an
Best Practices: alcohol-based surgical hand rub.
■ Recommended in healthcare settings where high Scrub hands, wrists, and forearms for 2–5
infection control is needed. minutes using proper technique.
■ Avoid excessive use, as it may cause skin irritation. • Use a sterile towel to dry hands and
arms before wearing sterile gloves.
4. Antiseptic Hand Rubs
Apply a sufficient amount to cover all hand surfaces. Best Practices:
■ Rub hands together for at least 30 seconds until dry.
■ Do not rinse after application. • Essential before surgical procedures to
■ prevent infections in the operating
Best Practices: room.
■ Preferable in clinical and surgical settings where high-
• Maintain sterility by avoiding
level hand disinfection is required. contamination after scrubbing.
■ Not a substitute for hand washing when hands are
visibly soiled.
B. Nail Hygiene Guidelines
Keep nails trimmed, short, and clean.
Avoid artificial nails or nail polish, especially in healthcare settings.
■ Regularly clean under fingernails to remove dirt and bacteria.
■
■ Best Practices:
■ Healthcare workers should maintain natural nails less than 0.5
cm long.
■ Avoid biting nails or using them to pick at objects to prevent
microbial contamination.
C. Hand Lotion and Skin Care Guidelines
Use hand lotion or moisturizer regularly to prevent skin dryness
from frequent hand washing.
Choose fragrance-free and alcohol-free lotions to reduce skin
irritation
■ Apply lotion after hand hygiene routines to restore moisture
balance.
■
■ Best Practices:
■ Avoid petroleum-based lotions when wearing latex gloves, as
they can weaken the glove material.
Use lotions from sealed dispensers instead of open containers to
prevent contamination.
GENERAL BEST PRACTICES FOR
HAND HYGIENE
Perform hand hygiene before and after patient
contact in healthcare settings.
Wash hands after touching contaminated
surfaces, sneezing, coughing, or handling food.
■ Avoid touching your face, eyes, nose, and
mouth with unclean hands.
■ Use disposable paper towels or hand dryers
instead of shared towels.
■ Educate and promote hand hygiene in
workplaces, schools, and public places.
ENVIRONMENTAL AND
SUSTAINABILITY CONSIDERATIONS
3 Water Conservation 4. Reduced Use of Paper Towels
Use cloth towels or air dryers instead of
Turn off taps while lathering hands to
reduce water wastage. disposable paper towels.
• If using paper towels, choose those
■ Use water-efficient faucets or sensor- made from recycled materials.
based taps.
2. Eco-Friendly Soap and Sanitizers 5. Proper Disposal of Hygiene Products
Dispose of wipes and tissues properly to
■ Choose biodegradable and non-toxic prevent littering.
soaps to avoid water pollution. • Avoid flushing non-biodegradable wipes,
■ Use alcohol-based hand sanitizers with as they contribute to water pollution.
natural ingredients
6. Responsible Use of Hand Sanitizers
3. Sustainable Packaging • Use only when necessary to reduce
Opt for refillable soap dispensers instead of chemical exposure and waste.
single-use plastic bottles. • Choose plant-based or organic
alternatives where possible.
■ Support brands that use recyclable or
compostable packaging.
RESEARCH EVIDENCE
1. Hand Hygiene Reduces Hospital-Acquired
Infections: A systematic review of 26 studies
found that hand hygiene interventions reduced
hospital-acquired infections by 24%.
2. Alcohol-Based Hand Rubs (ABHRs) vs. Soap and
Water: A study published in the Journal of Hospital
Infection found that ABHRs were more effective
than soap and water in reducing bacterial
contamination on healthcare workers’ hands.
3. Electronic Hand Hygiene Monitoring Systems: A
study published in the American Journal of
Infection Control found that electronic hand
hygiene monitoring systems increased hand
hygiene compliance by 15%.
4. Impact of Hand Hygiene on Patient Outcomes:
A study published in the Journal of Patient Safety
found that improved hand hygiene compliance
was associated with reduced patient mortality,
morbidity, and length of stay.
CASE STUDY
A large teaching hospital observed an increase in
healthcare-associated infections (HAIs), especially among
patients in the intensive care unit (ICU). Most of these
infections were linked to multi-drug-resistant organisms
(MDROs). After an internal audit, it was discovered that
poor hand hygiene compliance among healthcare
workers (HCWs) was a major contributing factor.
Problem Identification
The hospital’s infection control team noticed
Hand hygiene compliance was below 50%.
Many HCWs were unaware of the WHO Five Moments for
Hand Hygiene.
Hand sanitizers were either unavailable or not used
correctly.
■ Some staff members believed wearing gloves alone
was sufficient.
INTERVENTION
1. Hand Hygiene Campaign: A month-long awareness program using
posters, workshops, and real-time demonstrations on proper hand
washing techniques.
2. Installation of Sanitizer Dispensers: Alcohol-based hand rubs were
placed at every patient’s bedside and entrance to wards.
3. Monitoring and Feedback: Infection control nurses observed HCW
compliance and provided instant feedback.
4. Incentives and Penalties: Staff who followed proper hand hygiene were
rewarded, while non-compliance led to mandatory retraining.
Outcome
After six months, compliance improved to 85%.
The rate of HAIs reduced by 40%.
1. Staff members became more conscious of infection control practices.
CONCLUSION
Hand hygiene is a fundamental practice in infection prevention and public
health. Throughout history, its significance has been recognized, evolving
from ancient rituals to modern evidence-based guidelines promoted by
organizations like the WHO and CDC.
Despite its importance, barriers such as lack of access, inadequate training,
and behavioral challenges hinder compliance. Overcoming these requires
multimodal strategies, including education, monitoring, and fostering a
culture of safety.
Additionally, sustainability considerations, such as water conservation, eco-
friendly products, and responsible waste disposal, are crucial for balancing
health benefits with environmental responsibility.
