Hand Hygiene

Did you know that four out of five germs that cause illness are spread by hands?

That's right. And that's why cleaning hands is one of the most important steps health care providers - and all of us - can take to prevent the spread of infection-causing germs. Numerous studies show that infections can be prevented in the hospital if health care providers use proper hand hygiene. Keeping your hands clean is an important way to avoid getting sick or spreading germs to patients, coworkers, etc.

At Michigan Medicine, our policy requires health care professionals to wash their hands or use a hand sanitizer before and after every patient contact. If you notice that someone has forgotten to practice appropriate hand hygiene, feel free to remind them. You may also report your concern or compliments via the web.

Please read the following tips and instructions on proper hand hygiene:

The Right Way to Wash Your Hands
When health care providers should wash their hands
When patients and visitors should wash their hands
Frequently Asked Questions
Additional Resources

The Right Way to Wash Your Hands

With soap and water:

Wet your hands with clean running water and apply soap. Use warm water if it is available.
Rub hands together to make a lather and scrub all surfaces.
Continue rubbing hands for 15 seconds.
Rinse hands well under running water.
Dry your hands using a paper towel or air dryer. If possible, use your paper towel to turn off the faucet.

If soap and clean water are not available and/or your hands are not visibly soiled, you can use an alcohol-based hand rub to clean your hands. Alcohol-based hand rubs significantly reduce the number of germs on skin and are fast acting. (Remember: alcohol-based hand rubs not effective against spore-forming bacteria as C. Difficile.)

Using an alcohol-based hand sanitizer:

Apply 1 pump of product to the palm of one hand.
Rub hands together.
Rub the product over all surfaces of hands and fingers until hands are dry.

Make sure your hands are completely dry prior to putting on gloves.
Wash your hands with soap and water when you feel a “build-up” of emollients on your hands.

When health care providers should wash their hands

Health care providers are expected to clean their hands with waterless hand sanitizer or soap and water:

Upon entering and exiting the room of hospitalized patients
Before touching each patient, whether or not gloves are worn
After touching each patient
After glove removal
Between activities on the same patient, for example, after a dressing change and before urinary or catheter care
After touching items soiled with blood or body fluid, such as wound dressings or bedpans
Before handling medications
Before preparing food
After personal activities, such as, use of the toilet, coughing or sneezing

When patients and visitors should wash their hands

Before eating. Use waterless hand sanitizer if in your car
Before, during and after handling or preparing food
After changing a diaper
After you use the bathroom
After handling animals, their toys, leashes or waste
After touching something that could be contaminated (such as a trash can, cleaning cloth, drain, or soil)
After sneezing, coughing or blowing your nose
Before dressing a wound, giving medicine or inserting contact lenses
More often when someone in your home is sick
Whenever they look or feel dirty.
Whenever you visit someone in the hospital or nursing home.

Remember, too, the importance of hand hygiene if you are providing care for a loved one at home or in the hospital. Clean your hands before and after every contact.

Hand Hygiene: Frequently Asked Questions

Why is hand hygiene important?
Washing your hands is one of the most important things you and your family can do to prevent illness. In fact, according to the Centers for Disease Control and Prevention, hand hygiene is the single most important means of preventing the spread of infection.

Clean hands can help protect you from infectious and food-borne illnesses. If you get sick, it can also keep you from passing your illness to others.

Most people don’t realize that four out of five germs that cause illness are spread by hands. Hand washing protects your health by removing the dirt and germs that get on your hands during almost all activities.

If you don't wash your hands, the germs on your hands can get into your mouth, nose, eyes, cuts and scrapes - even your food - and make you sick.

What if my hands look clean?
Even if your hands look clean, they can still have dirt and germs on them. Germs are too small to see with the human eye. They can only be seen through a microscope.

Are alcohol-based hand rubs really effective?
More than 20 published studies have shown that alcohol-based hand rubs are much more effective than either plain or antimicrobial soap in reducing the number of bacteria on the hands.

Why are alcohol-based hand rubs a good option?
Alcohol-based hand rubs are a good option because they are a convenient way to get rid of germs when your hands are not visibly soiled. Because water, soap and towels are not needed, hand sanitizers can be taken with you and used any time and any place.

For example, hand sanitizers can be carried in your purse, backpack and in your car. And of course, they can be kept throughout your home or office - giving you and your family a convenient way to get rid of the germs on your hands.

Won’t frequent use of alcohol-based hand rubs dry out my skin?
No! In fact, studies have proven that nurses who routinely cleaned their hands between patients by using an alcohol-based hand rub had less skin irritation and dryness than people who washed their hands with soap and water. Many alcohol-based hand rubs contain moisturizers (emollients) that help prevent dryness.

How many times can I use alcohol-based hand rubs before I need to wash my hands with soap and water?
Some people have advocated that you should wash your hands after every four or five uses of alcohol-based hand rub. But, there is no reason to do this. If your hands feel 'grubby' or are visibly dirty, you should wash them with soap and water.

When should I wash with soap and water?
Wash with soap and water when your hands are visibly soiled and when you feel like there is something on your hands. You can use an alcohol-based hand rub at all other times.

Isn’t the alcohol-based hand rub flammable? Should I be concerned about it being a fire hazard?
The typical alcohol-based hand rub containers are small and don’t contain a large quantity of the product, their contribution to the development, acceleration or spread of fire in most situations is small. It's best to keep open flames away from bottles of alcohol-based hand rubs and from your hands after using an alcohol-based hand rub until it has completely dried to further reduce the risk of fire.

Will widespread use of alcohol-based hand rub make it likely that bacteria will become resistant to it?
No. Many people have heard about this problem with antibacterial products which contain antibiotics and can contribute to making bacteria resistant. One advantage of alcohol-based hand sanitizers is that they do not contain antibiotics, so they will not make bacteria more resistant.

Can I become 'drunk' by using the alcohol-based hand rub?
So far, no studies have shown this. They have found that alcohol levels found in the blood after using alcohol-based hand rubs is insignificant.

Should I ask my health care provider if they have washed their hands before they touch me?
You should be involved in all aspects of your care and you should feel comfortable asking your health care provider if they have washed their hands before they take care of you.