Best practice for hand hygiene: washing and disinfection

Insufficient hand hygiene is one of the most common causes for spread of infectious diseases, while good hand hygiene is the most important factor in preventing spread of bacteria and infection.

In the health care sector, a structured approach to hand hygiene is essential for preventing infections. Read on for more tips about maintaining hand hygiene standards in the health care sector, from washing, disinfecting to drying and caring for dry hands and nails.

Hand disinfection should be performed when the hands are visibly clean and dry, while hand wash should performed if the hands are visibly soiled or wet. After washing, the hands should be disinfected, since washing with soap and water removes dirt, but does not kill microorganisms.

Best practice| Hand washing

Hand washing should be performed whenever the hands are visibly dirty or after using gloves. It is important to keep the skin intact and prevent rashes and skin irritation, and the best way to do this is to avoid excessive washing with soap and water. Frequent washing with soap and water dries out the skin and increases the risk of skin irritation and dermatitis. 

One solution is to use alcohol-based disinfectants as an alternative and supplement, and to only wash the hands when they are visibly dirty.  High lipid lotions and moisturizers, or ointments prescribed from a health care professional, can help treat dermatitis caused by hand washing. 

Tip: Washing with soap and water removes dirt, but does not kill microorganisms. In the health care sector, hand washing always precedes disinfection when the hands are visibly dirty, have been wet or been in contact with patients. 

  1. Rinse the hands under clean, running water, removing any visible dirt. 
  2. Apply enough soap to cover all hand surfaces including wrists. The risk of skin irritation is minimized when applying soap to wet hands. 
  3. Rub hands and wrists for at least 15 seconds. 
  4. Rub both thumbs, wash the surface of the nails with the hands closed and wash in between the fingers.
  5. Rinse hands thoroughly with water.
  6. Dry hands thoroughly with a single use towel. Use the same towel to turn off the faucet

The temperature of the water affects the soap’s exposure on the skin. The hotter the water, the higher the degreasing effect of the soap on the skin. The water temperature does not otherwise affect the quality of hand washing or the removal of dirt from the hands, although too hot water can damage the skin. The efficiency of the wash is dependent on using the correct handwashing method.

Best practice | Hand disinfection

Hand Disinfection - for when hands are visibly clean and dry 

Hands should be dry before applying an alcohol-based disinfectant, since disinfectants increases the skin’s permeability and contributes to breaking down the skins barriers.  If the skin’s permeability and suppleness is broken down, the skin can act as a reservoir and entry port for pathogenic microorganisms. For hand disinfection, an alcohol-based agent containing glycerol - Ethanol and isopropyl alcohol is used - Ethanol 70-85% is recommended for liquid hand disinfection and 80-85% for hand disinfectant gel.

Tip: Maintain an intact skin barrier by using a disinfectant with glycerol, which aids in protecting the skin.

  1. Apply disinfection to visibly clean and dry hands, including wrists and possibly forearms. 
  2. The amount used should keep the hands moist for 30 seconds. Count on using at least 3 ml each time. 
  3. Distribute evenly on both hands, every finger, between fingers, palms and possibly forearms.
  4. Continue rubbing until hands, wrists and forearms are completely dry.


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