Steps of Hand Hygiene [VIDEO]

Steps of Hand Hygiene [VIDEO]

Proper hand hygiene is the simplest yet most powerful defense against the spread of infections in both healthcare and everyday settings.

The Importance of Hand Hygiene in Preventing Infections

Good hand hygiene is one of the most effective ways to stop infections from spreading, especially in places like hospitals and other shared spaces.

Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) stress that keeping hands clean plays a major role in cutting down the transfer of harmful germs.

This is particularly crucial in healthcare settings, where the chances of healthcare-associated infections (HAIs) are higher than usual.

When it comes to hand hygiene, it's not just about a quick wash—it's about making sure every part of the hand is properly cleaned.

The WHO advises using a six-step handwashing technique that ensures every area of the hand is covered, significantly lowering the number of germs.

The CDC, on the other hand, offers helpful advice for everyday hand hygiene, recommending the use of soap and water or alcohol-based hand sanitizers when soap isn't available.

By blending the WHO’s thorough method with the CDC’s practical tips, both healthcare workers and the general public can maintain proper hand hygiene.

Doing this regularly goes a long way in stopping the spread of bacteria and viruses, ultimately keeping everyone healthier.

 

Steps of Hand Hygiene (WHO and CDC Combined)

  1. Wet Hands
    Start by wetting your hands under clean, running water. It doesn’t matter if the water is warm or cold—both work fine. After wetting your hands, turn off the tap to save water, then apply some soap.
  2. Lather Your Hands
    Rub your hands together to build up a good lather with the soap. Make sure you cover every part of your hands, including the palms, the backs of your hands, and between your fingers.
  3. Clean the Back of Your Hands
    Place the palm of one hand over the back of the other, interlace your fingers, and rub. This helps spread the soap over the backs of your hands and in between your fingers.
  4. Between the Fingers
    Now, interlock your fingers and rub the spaces between them. These areas are often neglected, so it’s important to clean between your fingers well.
  5. Backs of the Fingers
    With your fingers interlocked, rub the back of your fingers against the opposite palm. This step targets the backs of your fingers, which are often spots where bacteria can hide.
  6. Thumbs
    Grip your thumb with the opposite hand and rotate it to scrub it thoroughly. This ensures you clean your thumb, an area that people tend to forget about.
  7. Fingertips
    Rub the tips of your fingers in a circular motion on the palm of your opposite hand. Pay special attention here, as this helps to clean under your fingernails, where germs can gather.
  8. Scrub for 20 Seconds
    Make sure you scrub your hands for at least 20 seconds to effectively reduce the amount of germs. An easy way to time this is by humming the “Happy Birthday” song twice.
  9. Rinse Your Hands
    Rinse your hands well under clean, running water to wash away the soap and any loosened dirt or microbes. Make sure every part of your hands is thoroughly rinsed.
  10. Dry Your Hands
    Dry your hands using a clean towel, or let them air dry. Be sure your hands are completely dry, as damp hands can easily pick up more germs.

By following these steps, which combine WHO’s six-step method with CDC’s broader guidelines, you can ensure every part of your hands is cleaned properly.

Consistently adhering to these techniques is a key way to help stop the spread of germs and reduce the risk of infections.

 

WHO Six-Step Technique (for Healthcare Settings)

The WHO’s six-step hand hygiene method is designed to ensure thorough cleaning in healthcare environments where infection risks are significantly higher. This method systematically covers all areas of the hands to minimize the presence of harmful microbes:

  1. Palm to Palm
    Start by rubbing your hands together, palm to palm. This ensures the front surfaces of both hands are fully covered with soap or sanitizer.
  2. Back of Hands
    Rub each palm over the back of the opposite hand while interlacing your fingers. This helps clean the backs of your hands and the spaces between your fingers, which are often missed.
  3. Between Fingers
    Interlock your fingers and rub between them. This step ensures that the spaces between your fingers, where bacteria commonly hide, are properly cleaned.
  4. Backs of Fingers
    With your fingers still interlaced, rub the backs of your fingers against the opposite palm. This action focuses on thoroughly cleaning the back surfaces of your fingers.
  5. Thumbs
    Wrap one hand around the thumb of the other hand and rotate it. The thumb is often neglected, so this step is important to ensure it's cleaned well.
  6. Fingertips
    Rub the fingertips of one hand in a circular motion on the palm of your other hand. This targets the areas under your fingernails, where dirt and microbes tend to gather.

The WHO’s six-step technique is an evidence-based approach that has been shown to reduce the microbial load on healthcare workers’ hands.

Following each step is crucial in healthcare settings, where preventing infections is a top priority.

Research shows that areas like the thumbs and fingertips are often missed, yet they are essential for effective hand hygiene (Arias et al., 2016; Price et al., 2018).

By consistently using this structured process, healthcare professionals can greatly lower the risk of cross-contamination, helping to create a safer environment for both patients and staff.

 

Challenges in Compliance

Although the WHO’s six-step hand hygiene method is highly effective in reducing the spread of microbes, compliance with all the steps is often inconsistent—especially in fast-paced environments like healthcare. Some steps, particularly those involving the thumbs and fingertips, are commonly overlooked (Arias et al., 2016).

  1. Time Constraints
    Healthcare professionals are often working under intense time pressure, which can lead to shortcuts in hand hygiene. Rushing through the steps or skipping parts of the process reduces its effectiveness, particularly when caring for high-risk patients.
  2. Thumb and Fingertip Neglect
    Steps involving the thumbs and fingertips tend to be the most frequently neglected during handwashing. Unfortunately, these areas can harbor large amounts of bacteria. Skipping these steps increases the chance of microbial transmission (Arias et al., 2016; Price et al., 2018).
  3. Perception of Cleanliness
    There’s a common belief that a quick wash is enough as long as there’s no visible dirt. However, this misconception can undermine the thoroughness needed for effective hand hygiene, especially in healthcare settings where infection control is critical.
  4. Lack of Awareness
    Some healthcare workers might not fully understand the importance of each step in the process. Ongoing education and regular training are essential to reinforce adherence to the complete hand hygiene protocol.
  5. Monitoring and Accountability
    Without proper systems in place to monitor compliance, it can be difficult to ensure that workers are following the full six-step technique. Studies have shown that hand hygiene practices improve when monitoring systems or compliance reminders are in use.

Addressing these challenges is crucial to improving compliance with the WHO hand hygiene technique.

Reinforcing the importance of every step, especially the often-overlooked thumbs and fingertips, and providing continuous education and accountability measures are key.

Full adherence to the technique is essential for preventing healthcare-associated infections and safeguarding patient health (Arias et al., 2016; Price et al., 2018).

 

References

  1. Price, L., Melone, L., McLarnon, N., Bunyan, D., Kilpatrick, C., Flowers, P., & Reilly, J. (2018). A systematic review to evaluate the evidence base for the World Health Organization’s adopted hand hygiene technique for reducing the microbial load on the hands of healthcare workers. American Journal of Infection Control, 46(7), 814–823. https://doi.org/10.1016/j.ajic.2018.01.020
  2. Arias, A. V., Garcell, H. G., Ochoa, Y. R., Arias, K. F., & Miranda, F. R. (2016). Assessment of hand hygiene techniques using the World Health Organization’s six steps. Journal of Infection and Public Health, 9(3), 366–369. https://doi.org/10.1016/j.jiph.2015.11.006

 

Takeaway

Hand hygiene remains one of the most effective ways to prevent infections, especially in healthcare settings where the risk of healthcare-associated infections (HAIs) is high.

The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) both offer clear guidance on proper handwashing techniques, with the WHO’s six-step method ensuring comprehensive coverage to effectively reduce microbial load.

However, to be truly effective, it’s essential to follow all the steps.

Challenges such as time constraints, skipping over areas like the thumbs and fingertips, and misconceptions about what constitutes clean hands can weaken the impact of hand hygiene practices.

Addressing these issues through education, regular monitoring, and accountability is key to maintaining the highest standards of infection control.

By consistently following these evidence-based steps, healthcare workers and the general public alike can significantly reduce the spread of harmful microbes, contributing to a safer and healthier environment for everyone (Arias et al., 2016; Price et al., 2018).

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