Actual handwashing vs. sanitizer

[quazar]

I have noticed for a while that I am one of the few nurses who usually washes her hands with soap and water before and after patient contact, rather than using the hand sanitizer. Most (not all, but most) of my coworkers use a squirt of hand sanitizer and only wash hands if visibly soiled. I don't wash every time, say if I'm going in to just quickly adjust the fetal monitor, then I will just do a squirt of the sanitizer. However, when I am going in to do a full assessment, or of course to do anything invasive, absolutely I am washing my hands.

Once, when orienting to a new hospital, my preceptor actually told me to stop washing my hands "so much" and that I "only needed" to use the hand sanitizer outside the doors and in the rooms. I just sort of let that go in one ear and out the other, and whenever she wasn't with me, I washed my hands like I usually do.

From what I can tell from the CDC guidelines, sanitizer is supposed to be used in the absence of soap and water, but then I hear infection control nurses say you can use it interchangeably except of course with GI viruses which require hand washing.

What is your practice? ETA: I'm wondering if I'm overdoing it, and maybe the other nurses are right and I could be using the hand sanitizer instead of hand washing except for with invasive procedures?

[hawaiicarl, BSN, RN]

Our facility has a "Gel in, Gel out" policy, we are not allowed to enter a pt's room without hand gel on the way in and the way out. They even have secret shoppers who observe staff, and turn you in if you don't! Handwashing is recommended for visible soiling, or after several gels to remove "debris". From all I have heard the latest from CDC is they want more research done, as they fear the constant gel use is creating super bugs. In the future they may ditch gel, and move back to good old handwashing.

Cheers

[Malenurse1235954]

I guess it depends whos study you read. Overwashing can lead to dry cracked hands which harbors germs in the microcracks. I have seen for myself glowgerm is not removeable from inside these microcracks. Proper handwashing can take take up to a minute which overworked nurses can often neglect. Hand sanatizer does kill most bugs (not cdiff) and proper hand sanitizing can be done quick and while walking to the next room. Also, if you are the type that always has gloves on you probably discarded germs in the first place. I wash when the hand sanitizer residue builds up and gets sticky, but Im a guy and statistically have bad handwashing.

I did my capstone project on hand washing and it swayed me against routine handwashing. Someday perhaps I will look at studies supporting alcohol hand sanitizing as roitine betqeen patients. For now I am convinced such frequent hand washing requires lotion to prevent dry hands

[FurBabyMom, MSN, RN]

I'm in the OR. I scrub and circulate. The general hospital infection control policy says either soap and water or hand sanitizer is okay, except patients on enteric precations or where hands are visibly soiled. That said, there is an additional 40ish page policy addressing surgical services/the OR and other procedure areas. Our facility allows nail polish, even in the OR but it cannot be cracked or chipped (no artificial nails if in a patient care role).

Because of how my environment is set up, I have to leave my room to wash my hands - so I generally use the alcohol sanitizer stuff. I do, after a few times using the alcohol sanitizer, wash my hands to remove the sticky stuff. While this is off topic, we can use either the soap and water scrub option or the waterless option when scrubbing for procedures. When I leave the room for a break, lunch or the end of the day I absolutely wash my hands with soap and water whether I'm scrubbing or circulating.

[quazar]

I'm in the OR. I scrub and circulate. The general hospital infection control policy says either soap and water or hand sanitizer is okay, except patients on enteric precations or where hands are visibly soiled. That said, there is an additional 40ish page policy addressing surgical services/the OR and other procedure areas. Our facility allows nail polish, even in the OR but it cannot be cracked or chipped (no artificial nails if in a patient care role).

Because of how my environment is set up, I have to leave my room to wash my hands - so I generally use the alcohol sanitizer stuff. I do, after a few times using the alcohol sanitizer, wash my hands to remove the sticky stuff. While this is off topic, we can use either the soap and water scrub option or the waterless option when scrubbing for procedures. When I leave the room for a break, lunch or the end of the day I absolutely wash my hands with soap and water whether I'm scrubbing or circulating.

This is most helpful, thank you!

Thanks y'all, this has been a really educational thread. Y'all are awesome.