Selected Podcast
Appropriate Hand Washing
Casey Benson Quality discusses hand washing techniques. She shares the latest CDC and WHO indications for handwashing, helps us to understand when to use alcohol-based hand sanitizer vs soap and water, and teaches us the proper technique for handwashing.
Featuring:
Casey Benson, BS, MS, CIC
Casey Benson, BS, MS, CIC is the Infection Preventionist at Carle Foundation Hospital.
Transcription:
Introduction: Expert Insights is an ongoing medical education podcast. The Carl division of continuing education designates that each episode of this enduring material is worth a maximum of 0.25 AMA PRA category one credit to collect credit, please click on the link and complete the episodes Post-test This podcast forum is brought to you to share expertise and insights within our integrated delivery system. To help us improve the health of the people we serve and achieve world-class accessible care. This is Expert Insights. Here's your host, Melanie Cole,
Melanie Cole: Welcome to Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole, and today we're discussing appropriate Hand-washing. Joining me is Casey Benson. She's an Infection Preventionist with the Carle Foundation Hospital. Casey, it's a pleasure to have you on in these unprecedented times. Now everybody's hearing the terms hand-washing and while we've all known, we're supposed to wash our hands. Tell us the latest information regarding the CDC and the World Health Organization indications for hand washing.
Casey Benson: Absolutely. So I think that one of the most important things is making sure that we're washing our hands, but not only that we're washing our hands, but also that we're washing our hands at the right times. So especially in healthcare we need to use at least alcohol based hand sanitizers before touching a patient before putting gloves on before we're doing any sort of a septic task. One thing that people sometimes forget is when moving from a dirty body part or a dirty task to a clean task on a patient. And then of course after removing gloves or after leaving the patient's care environment, it's important to use alcohol based hand sanitizer. And then even, you know, in our daily lives, if your hands are visibly soiled, after going to the restroom before eating, after touching items that are high touch surfaces, like light switches, any sort of shared desk space or computers, even at the grocery store, making sure you're cleaning your hands after touching the carts. And those kinds of shared surfaces is really important.
Host: Well then let's talk about the difference, help us to understand when to use alcohol based hand sanitizer versus soap and water, because you've mentioned both, tell us really what's the difference. And a lot of people don't understand why they should bother washing their hands when there is sanitizer around.
Casey Benson: Yeah, that's a great point. And I think an important distinction that surprisingly enough, a lot of people don't realize that alcohol based hand sanitizer is really the most effective product for removing germs from your hands is actually the preferred method for cleaning your hands in most clinical situations. And that's why you see that we have it all over the hospitals and all over clinics. It's really what we would prefer that you use in most situations. But of course there are exceptions to that. So we would prefer an alcohol based hand sanitizer in the patient care area when doing any of those tests that I mentioned such as, you know, before touching a patient, before and after gloving, and doing a septic tasks, but soap and water is really important. If your hands have visible soil on them, of course the hand sanitizer is not going to be able to get that visible soil off. And also when caring for somebody with an infectious diarrhea specifically, if they have suspected C diff, alcohol based hand sanitizer will not kill C diff. So it's really important to use soap and water to rinse that. So spores off of your hand, when they're potentially contaminated
Host: Wow. Information that I'm sure not very many people realized that hand sanitizer doesn't kill C diff. That's such a great point and what a great tip you've given us, Casey. So does the kind of soap matter, does it need to be antibacterial soap or just plain old Ivory soap? Does the type of soap matter?
Casey Benson: It depends on where you are. So, and home situation, regular plain old soap is all that you need. The CDC does recommend anti-microbial soap for healthcare area. So we do carry that within our patient care areas, but outside of that, really any sort of standard soap will do the trick.
Host: What about hot versus cold water, does that matter?
Casey Benson: Warm water is preferred. We have to be careful too with scalding and there's other concerns with it being too hot. But warm water is preferred.
Host: So, then give us the proper hand washing technique, kind of talk us through what you tell people and what you teach people every day?
Casey Benson: Sure. So when, when using soap and water for washing your hands, when you turn the sink on, that should really be the last time that you're touching the handles. That's something that I think people sometimes forget is, you know, when you're finished washing your hands, you want to use an elbow or some other way of turning the water off. Before you start washing your hands, you also want to make sure that you have your paper towel or drying wherever you can use to dry your hands available. So if that means you need to touch maybe the reel of the paper towel holder, go ahead and do that before you start washing your hands so that your paper towel is available for you. Once your hands are clean. So you're going to wet your hands. You're going to put the soap on your hands and then you need to wash your hands 15 to 20 seconds. There's some conflicting information about the right time, but 15 to 20 seconds is what CDC would recommend. And then you want to make sure that you cover all surfaces of your hands.
There's a whole step, there's a multistep process to follow to properly wash your hands. And it basically just includes making sure that the palms are washed, but the backs of your hands are also washed. Common places that people forget are their thumbs and their fingertips. So that's also included making sure that you get both in between your fingers and your fingertips. One of the last steps of proper hand washing is actually taking your fingertips and scrubbing the palm of your hand. That also helps clean up under your fingertips, or I'm sorry, under your fingernails. And then you're going to rinse with water with your hands, sort of pointed down so that all of the water, the soap and the germs that they're carrying off with them are, are going down into the sink as you rinse your hands off and then drying your hands. And then with an alcohol based hand sanitizer, pretty simple, but very similar, just making sure that you get enough product in your hand to cover all of the surfaces of your hand. And it should stay on your hands again, about 15 to 20 seconds. And that's how you know that you have enough product on your hands.
Host: Thank you for that very comprehensive lesson. So for lay folk versus healthcare providers, do we wash our hands differently and should we all be doing the surgical wash and the wash that you just described now?
Casey Benson: So really we should all be doing it the same, not necessarily a surgical scrub that is even more detailed. But the one that I described is really the one that we should always be doing regardless where we are and what kind of environment we're working in. It's really the best way to make sure that you're washing them adequately. Every time you go to wash your hands.
Host: Then wrap it up for us, Casey, with really good advice, because now hand washing is more important than it's ever been. Maybe it's not more important. It is more top of conversation and top of mind than it's ever been. And more people are realizing that it's really important and yet healthcare providers have been doing it forever. So please just wrap it up for us with your best advice about hand-washing when it's really appropriate to wash your hands versus sanitizer, kind of summarize it all for us.
Casey Benson: So I think, you know, it is top of everybody's mind. It's just as important as it's ever been. It's finally getting the attention that it's always needed. It is one of the most simple things that we can do both inside healthcare and in our own lives for our own health and wellness. It's one of the most simple things we can do. And one of the most often overlooked things that we just forget to do where we don't do it adequately. So it's great to shed a light on how important it is. It is really, you know, in our world of infection prevention. The number one thing that you can do to prevent infections in healthcare is washing your hands. So I'm glad that people are paying attention to hand washing, making sure they're doing it properly and making sure they're doing it at the right time
Host: Beautifully said, and such important message for people to hear, really all the time, but especially now, thank you so much, Casey, for joining us today. And that concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers, and to view Carle sponsored educational activities, please visit our website at carleconnect.com for more information, and to get connected with one of our providers. We hope the information gained will be applicable to your work and life. I'm Melanie Cole.
Introduction: Expert Insights is an ongoing medical education podcast. The Carl division of continuing education designates that each episode of this enduring material is worth a maximum of 0.25 AMA PRA category one credit to collect credit, please click on the link and complete the episodes Post-test This podcast forum is brought to you to share expertise and insights within our integrated delivery system. To help us improve the health of the people we serve and achieve world-class accessible care. This is Expert Insights. Here's your host, Melanie Cole,
Melanie Cole: Welcome to Expert Insights with the Carle Foundation Hospital. I'm Melanie Cole, and today we're discussing appropriate Hand-washing. Joining me is Casey Benson. She's an Infection Preventionist with the Carle Foundation Hospital. Casey, it's a pleasure to have you on in these unprecedented times. Now everybody's hearing the terms hand-washing and while we've all known, we're supposed to wash our hands. Tell us the latest information regarding the CDC and the World Health Organization indications for hand washing.
Casey Benson: Absolutely. So I think that one of the most important things is making sure that we're washing our hands, but not only that we're washing our hands, but also that we're washing our hands at the right times. So especially in healthcare we need to use at least alcohol based hand sanitizers before touching a patient before putting gloves on before we're doing any sort of a septic task. One thing that people sometimes forget is when moving from a dirty body part or a dirty task to a clean task on a patient. And then of course after removing gloves or after leaving the patient's care environment, it's important to use alcohol based hand sanitizer. And then even, you know, in our daily lives, if your hands are visibly soiled, after going to the restroom before eating, after touching items that are high touch surfaces, like light switches, any sort of shared desk space or computers, even at the grocery store, making sure you're cleaning your hands after touching the carts. And those kinds of shared surfaces is really important.
Host: Well then let's talk about the difference, help us to understand when to use alcohol based hand sanitizer versus soap and water, because you've mentioned both, tell us really what's the difference. And a lot of people don't understand why they should bother washing their hands when there is sanitizer around.
Casey Benson: Yeah, that's a great point. And I think an important distinction that surprisingly enough, a lot of people don't realize that alcohol based hand sanitizer is really the most effective product for removing germs from your hands is actually the preferred method for cleaning your hands in most clinical situations. And that's why you see that we have it all over the hospitals and all over clinics. It's really what we would prefer that you use in most situations. But of course there are exceptions to that. So we would prefer an alcohol based hand sanitizer in the patient care area when doing any of those tests that I mentioned such as, you know, before touching a patient, before and after gloving, and doing a septic tasks, but soap and water is really important. If your hands have visible soil on them, of course the hand sanitizer is not going to be able to get that visible soil off. And also when caring for somebody with an infectious diarrhea specifically, if they have suspected C diff, alcohol based hand sanitizer will not kill C diff. So it's really important to use soap and water to rinse that. So spores off of your hand, when they're potentially contaminated
Host: Wow. Information that I'm sure not very many people realized that hand sanitizer doesn't kill C diff. That's such a great point and what a great tip you've given us, Casey. So does the kind of soap matter, does it need to be antibacterial soap or just plain old Ivory soap? Does the type of soap matter?
Casey Benson: It depends on where you are. So, and home situation, regular plain old soap is all that you need. The CDC does recommend anti-microbial soap for healthcare area. So we do carry that within our patient care areas, but outside of that, really any sort of standard soap will do the trick.
Host: What about hot versus cold water, does that matter?
Casey Benson: Warm water is preferred. We have to be careful too with scalding and there's other concerns with it being too hot. But warm water is preferred.
Host: So, then give us the proper hand washing technique, kind of talk us through what you tell people and what you teach people every day?
Casey Benson: Sure. So when, when using soap and water for washing your hands, when you turn the sink on, that should really be the last time that you're touching the handles. That's something that I think people sometimes forget is, you know, when you're finished washing your hands, you want to use an elbow or some other way of turning the water off. Before you start washing your hands, you also want to make sure that you have your paper towel or drying wherever you can use to dry your hands available. So if that means you need to touch maybe the reel of the paper towel holder, go ahead and do that before you start washing your hands so that your paper towel is available for you. Once your hands are clean. So you're going to wet your hands. You're going to put the soap on your hands and then you need to wash your hands 15 to 20 seconds. There's some conflicting information about the right time, but 15 to 20 seconds is what CDC would recommend. And then you want to make sure that you cover all surfaces of your hands.
There's a whole step, there's a multistep process to follow to properly wash your hands. And it basically just includes making sure that the palms are washed, but the backs of your hands are also washed. Common places that people forget are their thumbs and their fingertips. So that's also included making sure that you get both in between your fingers and your fingertips. One of the last steps of proper hand washing is actually taking your fingertips and scrubbing the palm of your hand. That also helps clean up under your fingertips, or I'm sorry, under your fingernails. And then you're going to rinse with water with your hands, sort of pointed down so that all of the water, the soap and the germs that they're carrying off with them are, are going down into the sink as you rinse your hands off and then drying your hands. And then with an alcohol based hand sanitizer, pretty simple, but very similar, just making sure that you get enough product in your hand to cover all of the surfaces of your hand. And it should stay on your hands again, about 15 to 20 seconds. And that's how you know that you have enough product on your hands.
Host: Thank you for that very comprehensive lesson. So for lay folk versus healthcare providers, do we wash our hands differently and should we all be doing the surgical wash and the wash that you just described now?
Casey Benson: So really we should all be doing it the same, not necessarily a surgical scrub that is even more detailed. But the one that I described is really the one that we should always be doing regardless where we are and what kind of environment we're working in. It's really the best way to make sure that you're washing them adequately. Every time you go to wash your hands.
Host: Then wrap it up for us, Casey, with really good advice, because now hand washing is more important than it's ever been. Maybe it's not more important. It is more top of conversation and top of mind than it's ever been. And more people are realizing that it's really important and yet healthcare providers have been doing it forever. So please just wrap it up for us with your best advice about hand-washing when it's really appropriate to wash your hands versus sanitizer, kind of summarize it all for us.
Casey Benson: So I think, you know, it is top of everybody's mind. It's just as important as it's ever been. It's finally getting the attention that it's always needed. It is one of the most simple things that we can do both inside healthcare and in our own lives for our own health and wellness. It's one of the most simple things we can do. And one of the most often overlooked things that we just forget to do where we don't do it adequately. So it's great to shed a light on how important it is. It is really, you know, in our world of infection prevention. The number one thing that you can do to prevent infections in healthcare is washing your hands. So I'm glad that people are paying attention to hand washing, making sure they're doing it properly and making sure they're doing it at the right time
Host: Beautifully said, and such important message for people to hear, really all the time, but especially now, thank you so much, Casey, for joining us today. And that concludes this episode of Expert Insights with the Carle Foundation Hospital. For a listing of Carle providers, and to view Carle sponsored educational activities, please visit our website at carleconnect.com for more information, and to get connected with one of our providers. We hope the information gained will be applicable to your work and life. I'm Melanie Cole.