Not Another Silly Article on Hand Hygiene!

madwife2002, BSN, RN

I know we have numerous articles and threads on Infection Control and hand washing but it appears to me that the minority of healthcare workers actually are not washing their hands as often as they should.

A sad fact is although we maybe washing our hands, there are other people out there who do not wash their hands.

Now in my mind's eye, I can see you all gasp and feel indignant at my written words but stop for a minute and consider this statement; Do you always and I mean always sanitize or wash your hands after every interaction with the patient, after leaving their room, after touching door handles, after shaking hands with relatives?

I have this inner Police Woman (PW) living in my brain, she reminds me of the main character in the book 'The Host' who has an alien living in her body taking over her brain, my inner Police Woman wakes up when I go to violate the hand washing policy and says to me 'GO wash your hands' or even "Put on your Gloves'

My Inner PW will also be actively awake when using public bathroom facilities and I go to leave!

The shouting in my head often causes me to stop in my tracks, to consider my options.

PW will say to me "Did the last person who touched the bathroom door actually wash their hands?" Or did they just shake and walk?"

Visions of nastiness come to my mind with these words filling me with horror! So I either sanitize my hands after leaving the bathroom or I will open the door with the paper towel I have just dried my hands with.

Now I know you are thinking to yourself this Gal is crazy, she is OCD but I can assure you I am not! I am just becoming more acutely aware that I do not want transfer from other people's poor hygiene.

In my new role I have become increasingly aware of how we are often oblivious to when we should cleanse our hands, now don't get me wrong we are washing our hands but we are not washing them as often as we should, or more importantly when we should.

Just stand and watch people in your working environment for 5 minutes, contemplate what they are doing and consider if they should or should not sanitize their hands before or after the task they are performing? Watch them touch their hair, their face, their mouth then they shake somebodies hand, touch the door, touch the pen, lean on the door and retouch their face.

Now imagine that the relative whose hand you just shook, has just been to the bathroom, not washed his hands and opened the bathroom door where only 7 out of the previous 10 people who used the bathroom actually washed their hands. It is starting to sound like a horror story, isn't it? Then because we don't want to appear rude to the visitor we don't rush to wash or sanitize our hands immediately as you fear you will offend them, so you stand and talk with the visitor and then touch your face unconsciously. After leaving the room you then sanitize your hands because this is an acceptable time to wash, visitors and patients expect it.

I guarantee if you stand and watch others you will quickly see how we contaminate each other, our environment and our patients. I also guarantee you will see lots of good hand hygiene practice but you will also see the errors we all make. It will only take 5 mins of your time, and you will learn more by watching than reading this silly article!

I dare you go and do it!

Music in My Heart · Mar 29, 2013

I freely, but somewhat ashamedly, admit that my hand hygiene is less than 100%... and this is true of every nurse and every doctor and every RT with whom I've worked.

This is one of the reasons that I wear gloves nearly every time I will be touching a patient and why I sani-wipe the screens, keyboards, mice, tables, etc - as well as the gurney - between nearly every patient.

I also seek to avoid touching patients as much as possible.

And try to gel up every time I think about it, whether I've touched a patient or not.

Multiple levels hopefully means my potential for transmission is below 99.9%.

tewdles, RN · Mar 29, 2013

My anecdotal observation of hand washing in the acute care setting (where I do not work but spend a great deal of time) is that nurses are best at putting hand hygiene high on their priority lists. MDs not so much, in fact, sometimes their lack of infection control occurs on so many levels (outside of the OR) that it may well "undo" the good hygiene effects of the others.

i_love_patient_care · Mar 30, 2013

My anecdotal observation of hand washing in the acute care setting (where I do not work but spend a great deal of time) is that nurses are best at putting hand hygiene high on their priority lists. MDs not so much, in fact, sometimes their lack of infection control occurs on so many levels (outside of the OR) that it may well "undo" the good hygiene effects of the others.

Yeah I saw a doctor taking off dirty wound dressings with bare hands, and then applying the clean ones right after that. No handwashing in between! I'd never dream of calling them out, but seriously, wow...

amygarside · Mar 30, 2013

It seemed a trivial matter but washing hands can really save us from diseases.

Anoetos, BSN, RN · Mar 30, 2013

When performing my assessments and at other times during routine care, unless the patient is on contact precautions, I touch them with bare hands because, well, they're people, not vectors. But I am not stupid about it, I wear gloves for the feet or for intimate care and so on. I always foam in and foam out, and I do a good soap washing every hour or so, or before and after contact with a patient on C diff precautions, or when obviously indicated. If this is inadequate, I am not sure what to say

**Spidey's mom, ADN, BSN, RN** · Mar 30, 2013

You are not crazy. I'm the same way. Wondering where that hand has been before I shake it.

I also wipe off the handles of shopping carts before I touch them and open doors with the paper towel I dried my hand on.

Just the idea of someone wiping their tush and not washing their hands and then going on to touch so many things . . . . .

Money for one is very dirty - I hate it when a food person counts my money back with gloves on and then goes over to make a sandwich for the next person with the same gloves! I always say something!

Anoetos, BSN, RN · Mar 30, 2013

You all do know that the human immune response developes by way of exposure, right?

Being careful is one thing, washing everything obsessively seems, well, obsessive

**Spidey's mom, ADN, BSN, RN** · Mar 30, 2013

You all do know that the human immune response developes by way of exposure, right?
Being careful is one thing, washing everything obsessively seems, well, obsessive

Yep! That's why I always let my kids get dirty. I was not one of those obsessive moms who never let her kids play in the dirt!

But . .. being cautious about the handles of shopping carts (that guy who had it before just dug the Copenhagen out from under his upper lip with his right pointer finger and then grabbed the shopping cart to put back in the line . . . ) or money (no, don't make my sandwich with the same gloves you used to count back change) . . . isn't unreasonable! :)

I loved microbiology - best class ever!

psu_213, BSN, RN · Mar 30, 2013

But . .. being cautious about the handles of shopping carts (that guy who had it before just dug the Copenhagen out from under his upper lip with his right pointer finger and then grabbed the shopping cart to put back in the line . . . )

I don't necessarily disagree with cleaning a shopping cart handle. However, that guy may have dug his Copenhagen out (or had another C diff attack in the bathroom and didn't wash his hands) right before he touched that tomato you are about to take home. :yuck:

**Spidey's mom, ADN, BSN, RN** · Mar 30, 2013

I don't necessarily disagree with cleaning a shopping cart handle. However, that guy may have dug his Copenhagen out (or had another C diff attack in the bathroom and didn't wash his hands) right before he touched that tomato you are about to take home.

Which is why I wash ALL fruit and veggies before I eat them.

The folks who picked them may have used the portable toilet and didn't wash their hands.

:)

KelRN215, BSN, RN · Mar 31, 2013

You are not crazy. I'm the same way. Wondering where that hand has been before I shake it.
I also wipe off the handles of shopping carts before I touch them and open doors with the paper towel I dried my hand on.
Just the idea of someone wiping their tush and not washing their hands and then going on to touch so many things . . . . .
Money for one is very dirty - I hate it when a food person counts my money back with gloves on and then goes over to make a sandwich for the next person with the same gloves! I always say something!

The glove thing drives me nuts too... wearing gloves serves no purpose if you wear the same pair of gloves all day long. I see people doing this in sandwich shops and cafeterias all the time.

Not Another Silly Article on Hand Hygiene!

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