Question about hand hygiene

[michiganstudent]

I'm watching my nursing skills DVD's that were assigned before I start class, and I've noticed that none of the nurses or students wash their hands - at all. They only use Purell.

Is this simply product placement? Do nurses wash their hands in a hospital/clinical setting? I know Purell is supposed to kill germs, but it surprises me a little that soap and water are never, ever used on these videos.

I come from a family with mild OCD about these types of things. Am I overreacting?

[KelRN215, BSN, RN]

Purell doesn't kill C-Diff so anytime you come out of the room of a patient with C-Diff you should be washing with soap and water. I used soap and water in the hospital anytime I actually touched bodily fluids. If I just changed a diaper or changed linens with vomit I went right to the sink. For just entering and exiting rooms purell is sufficient.

[RLtinker, LPN]

When you go to clinicals, you find the use alcohol based disinfectants is common. At many places it is policy that whenever a nurse or other health care worker goes in or out of a room, they wash their hands. The alcohol based products are a good way to doing this quickly.There are literally people whose job it is to make sure this is being done. However, there are times when soap and water have to be used, but you will learn about that when you have lab.

[springchick1, ADN, RN]

I don't like hand sanitizers. A lot of them feel sticky to me so I'd rather just use soap and water.

[Philly_LPN_Girl, LPN]

I personally dont really like to use hand sanitizers too much especially while I am at clinicals. They feel sticky and I still feel like I have germs and dirt on my hands with sanitizer covering it lol.

Hand sanitizer is good BUT, depending what kind of isolation a pt is in, you must,wash your hands (c-diff, fungal, mrsa etc). I use sanitizer right after I walk out of a pts room then wash my hands

[michiganstudent]

Thank you for the responses! It reassures me that hand washing is still practiced.

BTW, hand sanitizer makes my hands feel dirty, too! I thought I was the only one who felt that way.

[Mewsin]

Hand sanitizer (we use avagard here) is the preferred method. Yes, it doesn't kill c-diff but think about it this way.

I touch a door knob walking into the room, I turn to the wall, pump avagard twice, "wash my hands" put my gloves on, do peri-care take my gloves off, pump avagard twice, finish with the resident, pump avagard twice, touch the door knob, open the door, turn to the outside wall, pump avagard twice, then I go to the sink and wash my hands. (This is how my facility is set up, we have a 90% rating for hand hygiene)

Otherwise I would have to touch the door knob, walk to the sink, wash my hands for 20 seconds, dry my hands, put my gloves on, do peri-care, take my gloves off, walk to the sink, wash my hands for 20 seconds, dry my hands, finish with the resident, walk to the sink, wash my hands for 20 seconds, dry my hands touch the door knob, walk down the hallway without touching anything and wash my hands for 20 seconds again. (This is how my clinical facility was set up, they didn't even have a 50% rating)

Alcohol based hand sanitizer is less drying on your hands, so your hands have less chance of cracking and cracking skin means more chance of you getting an infection. Alcohol based hand sanitizer saves time so people are more likely to do proper hand hygiene.

[VANurse2010]

In actual nursing practice, it is not realistic from a time perspective to wash your hands with soap and water every time hygiene is required.

[michiganstudent]

That does clear things up a little, Mewsin and VANurse. I was wondering if we would be washing at all. As much as hand hygiene is required, it makes sense to do both.

Thanks.

[michiganstudent]

Thank you for your expert advice~ That's exactly what I wanted to know!

I want to maintain good hygiene not only for my patients, but for myself and family.

(By the way, we love GOJO products at our house. I have 3 boys and a husband who use it religiously in the garage.)

[psu_213, BSN, RN]

For me, the foaming sanitizer leave my hands feeling cleaner (and often with a less strong smell without the oily feel) than a gel sanitizer. Hand washing is still necessary at many times though.

[KelRN215, BSN, RN]

In my current job as a home health nurse, I use Purell 99.9999% of the times. I work in the inner city and have some patients in the absolute ghetto... some of whom barely have running water in their houses. Some of whom I'm not convinced stock soap.