staffing solutions
The ABCs of Hand Washing
BY MARY JAMESON, BHS, COA, NCLC, CPOT

We tell our patients to wash their hands before handling contact lenses for obvious reasons. But do we really understand the benefits of good hand hygiene? You may be surprised how much there is to know about this procedure  that we take for granted.

What's the Difference in Soaps?

Washing our hands removes dirt, organic material and microorganisms. Different types of cleansers are available for hand hygiene.

• Plain soaps are detergent based. They're available in bar, liquid and powder forms. The detergent, along with mechanical rubbing, removes dirt, soil and organic substances from hands
• Anti-microbial soaps contain an additional antiseptic agent, such as alcohol or chlorhexidine
• Alcohol/antiseptic hand rub preparations contain alcohol or other antiseptic agents. They don't require rinsing and work best when hands are soil-free.

Hand Hygiene Basics

Throughout the day, germs accumulate on hands from a variety of sources: direct contact with people, contaminated surfaces, food and animals. A primary way to spread these germs is by touching these objects and then touching the eyes, nose or mouth.

Teach your patients how to properly wash their hands:

• Remove hand jewelry
• Wet hands with warm, running water
• Apply soap and lather well
• Rub hands together for 10 to 15 seconds
• Scrub all surfaces (back of hands, under fingernails, nail beds, wrists and between fingers)
• Rinse well
• Dry with a clean or disposable towel

Antibacterial soaps have become popular, but regular soap works fine. I instruct patients to use a soap that's free from perfumes, oils and deodorants. If they have dry skin, they can apply lotion after applying their lenses.

When using a hand sanitizer that doesn't require water:

• Make sure it's alcohol based
• Apply hand sanitizer to palm of hand
• Rub hands together until dry
• If hands are visibly dirty, then wash with soap and water

Practicing What You Preach

Studies indicate that among healthcare personnel, hand washing associated with patient care occurs in approximately half of the instances in which it's indicated and it's usually of shorter duration than recommended. The Association for Professionals in Infection Control and Epidemiology (APIC) recommends the following guidelines for washing hands in a healthcare setting:

1. Wash hands with soap and water when visibly soiled

2. Wash hands:

a. Before and after patient contact

b. After contact with a source of microorganisms

c. Before and after wearing gloves

d. After contact with equipment

e. Before and after eating

f. After using the restroom

3. Wet hands with running water. Apply hand washing agent and distribute over hands. Rub hands together for 10 to 15 seconds, covering all surfaces of the hands and fingers

4. For general patient care, use plain soap in any form

5. Use paper towels or hand dryers for drying

6. Alcohol-based hand rubs are adequate when hands aren't soiled with dirt or other organic material. Make sure that the hands are completely dry before proceeding

More Important Than You Think

In today's eyecare practice, the number-one way to prevent the spread of germs and infection is still good hand hygiene by doctors, staff and patients.

Ms. Jameson is laboratory supervisor for the Department of Clinical Sciences at the Pennsylvania College of Optometry and is a past chair of the AOA Paraoptometric Section.