Be Smart, Be Safe…and Celebrate!

If you read the CDC page for Global Handwashing Day, it sounds a bit like a primer for preventing (so-called) third-world problems:

Global Handwashing Day is a way to support a global and local culture of handwashing with soap, shine a spotlight on the state of handwashing in each country, and raise awareness about the benefits of handwashing with soap. Since 2008, Global Handwashing Day has been celebrated annually on October 15 worldwide.”

Even the issues and diseases the CDC highlights seem to refer to problems in the developing world:

  • “Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more effectively.
  • Millions of children under the age of 5 years die from diarrheal diseases and pneumonia, the top two killers of young children around the world.
  • Handwashing is not only simple and inexpensive, but remarkably, handwashing with soap can dramatically cut the number of young children who get sick.
  • Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infection, such as pneumonia.

But what if I were to tell you that the lack of basic hand hygiene is profoundly affecting us right here in the United States, making people sick and even causing death?

Better Hand Hygiene Needed Here

Most all of us grew up being told by our parents to wash our hands (after using the toilet, before dinner, etc). The habit should have become ingrained, but many of us drop habits, even those that are healthy, as we leave home and grow older.

It’s hard to imagine that handwashing gets short shrift, even in a healthcare setting, where infection control practices are of paramount importance.

But it’s true!

A large study of US hospitals demonstrated that fewer than half of all clinicians complied with recommended hand-washing guidelines, even in intensive care units. (This is not to say they didn’t wash their hands at all; only that they didn’t follow the recommended guidelines to minimize the risk of spreading infection.)

These few data points give you a glimpse of the scope of the problem:

  • A 12-month study assessing hand hygiene compliance rates revealed compliance rates of approximately 26% in intensive care units and around 36% for non-intensive care units. (After education and feedback, the units that were studied improved, but compliance still remained below 50%.) Think about how scary that is given that hand hygiene is the most important factor in preventing healthcare-acquired infections.
  • There are over 500,000 surgical site infections annually in the US with poor hand-hygiene defined as one of 3 major causes.
  • Infection caused during healthcare interactions are the most common adverse event and could be prevented by hand hygiene, but compliance with hand hygiene is often below 40%.
  • 5 to 10% of patients in the developed world acquire infections during healthcare interactions that could have been prevented by following basic hand hygiene protocols.

Clearly, we need a change.

Let’s make today the day we raise awareness about the problem, how to solve it, and get some tips on how to help others, including our healthcare providers, get on board.


So, What Is Proper Hand Hygiene?

A review of the basic how’s and why’s of good hand hygiene seems remedial, but let’s make sure everyone is getting it right…because it really could be a matter of life and death.

How should we wash our hands?

The CDC recommends a five step method (Wet, Lather, Scrub, Rinse, and Dry):

  • Many washing hands x510Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, under your nails, tips of the fingers, thumb, and up to your wrists.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them. (Use your towel to turn the water faucet off.)

The CDC also suggests that sanitizers are not a great substitute for the washing of hands:

Washing hands with soap and water is the best way to reduce the number of microbes on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.

Alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, but sanitizers do not eliminate all types of germs.

Hand sanitizers may not be as effective when hands are visibly dirty or greasy.

Why go to all this trouble? Because it really can be a matter of life and death. In fact, it is so critically important, that the WHO’s guidelines are 270 pages long!

Handwashing with soap removes germs from hands. The CDC explains why this helps prevent infections because:

  • People frequently touch their eyes, nose, and mouth without even realizing it. Germs can get into the body through the eyes, nose, and mouth and make us sick.
  • Germs from unwashed hands can get into foods and drinks while people prepare or consume them. Germs can multiply in some types of foods or drinks, under certain conditions, and make people sick.
  • Germs from unwashed hands can be transferred to other objects, such as handrails, table tops, or toys, and then transferred to another person’s hands.
  • Removing germs through handwashing helps prevent diarrhea and respiratory infections, and may even help prevent skin and eye infections.

So how do we make sure other people are getting it right?

What if you aren’t certain that the healthcare professional you’re seeing has followed the guidelines and done a thorough enough job to protect you as much as possible?

You might be uncomfortable with raising hygiene issues with him or her.

But no one will advocate for you as strongly as you can. It’s your life. So, stand up and make sure that whoever is touching you adheres to good hand hygiene practices.

Here are some easy phrases to practice so you’re ready to keep yourself as safe as possible in case your healthcare provider has a little lapse or you’re not absolutely certain you’re being approached with clean enough hands. (Remember too, that “clean” in a medical or dental setting means washing for at least 20 seconds):

“I’m embarrassed to even ask you this, but would you mind cleansing your hands before you begin?”

If your clinician replies, “Oh, I washed them right before I came in the room,” simply act like a broken record and ask again: “If you wouldn’t mind, I’d like you to do it again, in front of me.”

In the end, it’s your life and your health.

Put On Your Party Hats and Celebrate October 15th

Given the stakes, we can’t afford not to take proper hand hygiene seriously.

Obviously, the problems with bad hand hygiene are not limited to hospital settings: dentists, food service professionals, and just about everyone else could benefit from getting on board with better hand hygiene.

We all can make a difference. Use your social networks to share a message that matters. And this is a message that doesn’t require anyone to invest any money or go against their political beliefs.

All we need to do is start washing our hands…

Pass the word on October 15th!

How do you handle handwashing for yourself? Your kids? Your health care providers? Do you have any good solutions for how to boost handwashing rates? We would love to hear from you, leave a comment!