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#WeNurses - Not-so-simple hand hygiene

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Did you miss the latest #WeNurses chat which discussed hand hygiene? Let us sum it up for you…

When this #WeNurses chat was first suggested by Claire Kilpatrick (@claireekt) from the Infection Prevention Society I have to admit that I thought it was a little simplistic to be discussing hand hygiene with a group of nurses; however, I then started to think about it and I realised just how complex and interesting hand hygiene is. The single act of handwashing has such a massive impact on not only our patients but also wider public health.

@AshbyClare started this conversation by tweeting “Micro-organisms are everywhere! If we could see them I think we would wash our hands (and other things) more”

Some other first thoughts on hand hygiene that were shared at the start of this chat were:

@claireekt stated “It’s not a choice #handhygiene OR other patient care activities #ptsafety #5Moments

@bartontd said “A good video package from ABMU Health Board Wales Hand Washing”

michellemellor3 said “Terrible to see germs under ultraviolet lights, when you think they are clean following #handwashing”

‘Bartontd then asked “Question - Why don’t we remember the message? Wash your hands!”

@Sammy_Fischer said “Could it be pure laziness? Or something that isnt properly instilled in us during childhood?”

AshbyClare said “HCP to perform hand hygiene until it’s so ingrained they can’t get near a patient without doing it. Repeated behaviour = habit”

michellemellor3 tweeted “Nurses are busy people but should do the patient no harm- no excuse for not maintaining #handhygiene#washedhands”

salsa442 said “I am constantly shocked by lack of hand hygiene on some of the wards I go onto, even when the alcogel is there, pple walk past it”

Bartontd stated “Busy wards, to few nurses, not enough sinks - hand washing overlooked”

_Michael_Palmer.raised a very interesting point: “What impact does being a community practitioner have on ability to maintain adequate hand hygiene?”

claireekt answered “Handrub at the right times makes it easy, accessible, acceptable!”

Jo_France tweeted “We have are hand washing technique peer assessed yearly in the community”

salsa442 said “I rely on alcogel and always carry a small pot of liquid handwash when in community”

MRSAActionUK said “It’s difficult for people who are vulnerable at home if there isnt adequate washing facilities for HCWs to wash”

_Michael_Palmer responded “You’re right, and alcohol gel is not effective against all pathogens. What else can we do?”

salsa442 said “I totally agree, have liquid soap & paper towels if my pts will let me use their sink”

MRSAActionUK tweeted “Alco gel not effective on gastro infections, we should not rely on these”

@AshbyClare stated “Not as good as soap & water”

@claireekt had the final word here by tweeting some evidence: “It is, read 10yrs of solid work to prove @who”

WeNurses then asked “Are we assisting out pts to wash their hands too ? how ?”

TildaMc tweeted “We have hand wipes for those with poor mobility”

Sammy_Fischer said “Not enough before and after meals, given hand wipes but some patients dont know what they are until made aware!”

michellemellor3 stated “Offer #handwashing facilities to patients following WC & always prior to meals”

MRSAActionUK said “Very important and often forgotten, patients can re infect themselves with cdiff and other gastro infections, soap needed”

The more that I explore hand hygiene the more I realise that it is anything but simplistic. Do we wash our hands enough? Do we wash our hands thoroughly? If we aren’t, why aren’t we? What about our professional responsibility to our peers and patients? Are we really doing enough to ensure that that hand hygiene is firmly on our agenda?

One of my favourite tweets during this chat was from Claire Kilpatrick (@claireekt): “If you get the #5Moments #handhygiene fits into the natural workflow, it doesn’t have to take up extra time” and I think that as nurses the 5 moments (WHO - Clean care is safer care) are a good mantra. This approach recommends healthcare workers to clean their hands:

  • before touching a patient,
  • before clean/aseptic procedures,
  • after body fluid exposure/risk,
  • after touching a patient, and
  • after touching patient surroundings.

Claire very wisely said in her tweet that the ‘5 moments’ naturally fits into our workflow and I think that she has a very good point - I am certainly going to think about them the next time that I am on duty.

Teresa Chinn is a nurse, a blogger and social media specialist and leads the #WeNurses discussions for WeNurses. Follow @WeNurses on Twitter.

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