Hand hygiene guideline

1. VIRUS SURVIVAL

• Evidence suggests that the flu virus does not survive for long periods of time on soft items although it can survive up to 24 hours on hard surfaces.

• Hard, non-porous surfaces (e.g. stainless steel counter or plastic bowls): flu virus is able to survive for up to 72 hours but only for 24 hours in large enough quantities to pose a risk of infection

• Soft surfaces/furnishings (e.g. clothes, handkerchiefs, tissues, magazines): flu virus is able to survive for up to 12 hours but only for about 15 minutes in large enough quantities to pose an infection risk

• Once the virus is transferred to hands, it survives for less than five minutes

• Cleaning your hands with soap and water (followed by drying) according to the guidelines is an effective way to kill flu virus on your hands

• The flu virus is killed within 30 seconds by appropriate antiseptic handrub solutions

2. HYGIENE MEASURES

2.1 Hand hygiene

The risk of becoming infected with the virus is effectively reduced by following strict hand hygiene measures. Hands can be cleaned by washing with soap and water according to the guidelines or using appropriate antiseptic handrub solution. Hands must be decontaminated immediately after each and every episode or direct contact to an ill person or someone with flu symptoms and after any activity or contact that potentially results in hands becoming contaminated.

Hands that are visibly soiled or potentially grossly contaminated with dirt or organic material, e.g. after removal of gloves, must be washed with liquid soap and water. Hands should be decontaminated between caring for different patients and between different care activities for the same patient. For convenience and efficacy, an appropriate antiseptic handrub solution is preferable unless hands are visibly soiled. If antiseptic handrubs are used, hands should be washed with soap and water after several consecutive applications of the handrub.

Before a shift of work begins it is advisable that all wrist and, ideally, hand jewellery be removed. Cuts and abrasions must be covered with waterproof dressings. Fingernails are advised to be kept short, clean and free of nail polish. False nails and nail extensions must not be worn while attending to sick people.

An effective hand washing technique involves three stages: preparation, washing and rinsing, and drying.

Preparation requires wetting hands under running water before applying the recommended amount of liquid soap or an antimicrobial preparation. Soap must come into contact with all the surfaces of the hand.

The hands must be rubbed together vigorously with soap for a minimum of 10–15 seconds, and particular attention should be paid to the tips of the fingers, the thumbs and the areas between the fingers.

Hands should be rinsed thoroughly prior to drying with good-quality paper towels. When an antiseptic handrub solution is used to decontaminate hands, hands should be free of dirt and organic material. The handrub solution must come into contact with all surfaces of the hand. The hands must be rubbed together vigorously, with particular attention paid to the tips of the fingers, the thumbs and the areas between the fingers, until the solution has evaporated and the hands are dry or for not less than about 30 seconds.

It is advisable to use an emollient hand cream regularly, e.g. after washing hands before a break, or when going off duty and when off duty, to maintain the integrity of the skin.

If a particular soap, antimicrobial hand wash or antiseptic handrub solution causes skin irritation, review the methods described above before consulting a healthcare worker. An appropriate antiseptic handrub solution should be made available at the point of service delivery in all work environments where the hands of the workers could get contaminated. In work environment, hand hygiene resources and individual practice should be audited at regular intervals and the results fed back to working staff. Education and training in risk assessment, effective hand hygiene and glove use should form part of staff education and awareness.

2.2 Hands must be cleaned:

• When arriving at and leaving the workplace

• When arriving at home from work or outside activities

• Before and after direct contact with contaminated surfaces

• After contact with body secretions

• Before and after removing protective work clothing and gloves

• After handling soiled items

• Before handling food

• Before eating

• Before smoking

• Before touching your mouth, nose or eyes