|
|
| Line 1: |
Line 1: |
| − | {{howto}}
| + | A [[soft diet]] is recommended in many situations, including some types of [[dysphagia]] (difficulty swallowing), surgery involving the mouth or [[gastrointestinal tract]], and pain from newly adjusted [[dental braces|braces]]. |
| | | | |
| − | [[Image:SchoolchildrenWashingHands.jpg|right|thumb|Schoolchildren washing their hands before eating lunch.]]
| + | In some situations, there are additional restrictions. For example, patients who need to avoid excessive [[Gastroesophageal Reflux Disease|reflux]], such as those recovering from esophageal surgery for [[achalasia]], are also instructed to stay away from foods that can aggravate [[Gastroesophageal Reflux Disease|reflux]], which include ketchup and other tomato products, citrus fruits, chocolate, mint, spicy foods, alcohol, and caffeine. |
| − | '''Hand washing''' is the act of [[cleaning|cleansing]] the [[hand]]s with [[water]] or another [[liquid]], with or without the use of [[soap]] or other [[detergent]]s, for the [[Sanitation|sanitary]] purpose of removing [[soil]] and/or [[microorganism]]s.
| |
| | | | |
| − | ==Purpose==
| + | Many of the foods listed here can be adapted for a [[liquid diet|"full liquid"]] diet (not a [[liquid diet|"clear liquid"]] diet) by processing in a blender with an appropriate thinning liquid, such as a meat broth, fruit or vegetable juice, or milk. |
| − | [[Image:Fingerprint.jpg|left|thumb|An example of how minuscule particles can be caught between dermal ridges in the hand, yet remain unseen by the naked eye. Washing one's hands removes such contaminants.]]
| |
| − | The main purpose of washing hands is to cleanse the hands of [[pathogen]]s (including [[bacterium|bacteria]] or [[virus]]es) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field. The [[Centers for Disease Control and Prevention]] (CDC) has stated that "It is well-documented that the most important measure for preventing the spread of pathogens is effective handwashing." A large body of research is available on the topic.[http://www.globalhandwashing.org/Publications/Lit_review.htm]
| |
| | | | |
| − | While there are some claims that hot water may more effectively clean one's hands, there is no documented evidence of this claim. The temperature at which humans can withstand hot water cannot kill germs. There are undocumented claims that hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill microorganisms. A temperature that is comfortable for hand washing (about {{convert|45|C|F|0|lk=on|abbr=on}}) is not nearly hot enough to kill any microorganism. It takes a much higher temperature to effectively kill germs (typically {{Convert|100|C|F|lk=on|abbr=on}}).
| |
| | | | |
| − | ==Personal hand washing== | + | == Grains/starches == |
| − | To maintain good [[hygiene]], hands should always be washed after using the toilet, changing a diaper, tending to someone who is sick, or handling raw meat, fish, or poultry, or any other situation leading to potential contamination. Hands should also be washed before eating, handling or cooking food. Conventionally, the use of soap and warm running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean or disposable towel.<ref>[http://www.mayoclinic.com/health/hand-washing/HQ00407 Hand washing] from [[Mayo Clinic]]</ref> After drying, a dry paper towel should be used to turn off the water (and open the exit door if one is in a restroom or other separate room). Moisturizing [[lotion]] is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day.<ref>[http://www.tufts.edu/med/apua/Patients/handwashing.html Hand washing] from [[Tufts University]]</ref>
| |
| | | | |
| − | [[Antibacterial soap]]s have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature.<ref>{{cite journal |author=Weber DJ, Rutala WA |title=Use of germicides in the home and the healthcare setting: is there a relationship between germicide use and antibiotic resistance? |journal=Infect Control Hosp Epidemiol |volume=27 |issue=10 |pages=1107–19 |year=2006 |pmid=17006819 |doi=10.1086/507964}}</ref> However, antibacterial soaps contain common antibacterial agents such as [[Triclosan]], which has an extensive list of resistant strains of organisms. So, even if antibacterial soaps do not select for antibiotic resistant strains, they might not be as effective as they are marketed to be. These soaps are quite different from the non-water-based hand hygiene agents referred to below, which also do not promote [[antibiotic resistance]].<ref>[http://www.cdc.gov/cleanhands/ Clean hands] from the [[Centers for Disease Control and Prevention|CDC]]</ref>
| + | *Cooked cereals: oatmeal, porridge, Weetabix/Cream of Wheat |
| | + | *Macaroni & cheese |
| | + | *Mashed potatoes and gravy |
| | + | *Pasta cooked soft |
| | + | *Rice cooked soft |
| | + | *Skinless baked potatoes with sour cream or cream cheese |
| | | | |
| − | ==Medical hand washing==<!-- This section is linked from [[IgnazMa Semmelweis]] --> | + | == Protein == |
| − | [[Image:Hand desinfection test with blood agar plate.jpg|thumb|right|Microbial growth on a cultivation plate without procedures (A), after washing hands with soap (B) and after disinfection with alcohol (C).]]
| |
| − | The purpose of hand washing in the health care setting is to remove or destroy (disinfect) [[pathogens|pathogenic microorganisms]] ("germs") to avoid transmitting them to a patient. The application of water alone is ineffective for cleaning skin because water is unable to remove fats, oils, and proteins, which are components of organic soil. Therefore, removal of microorganisms from skin requires the addition of soaps or detergents to water. Plain soap does not kill pathogens. However, the addition of antiseptic chemicals to soap ("medicated" or "antimicrobial" soaps) does confer killing action to a hand washing agent. Such killing action may be desired prior to performing surgery or in settings in which antibiotic-resistant organisms are highly prevalent.<ref>[http://www.who.int/patientsafety/events/05/HH_en.pdf WHO Guidelines on Hand Hygiene in Health Care]</ref>
| |
| | | | |
| − | The proper washing of hands in a [[medicine|medical]] setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically for 15 to 20 seconds<ref>[http://www.handhygiene.net/handwashing.html APIC Guidelines for handwashing and hand antisepsis in health care settings.] American Journal of Infection Control. 1995;23:251-269</ref>. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towel. After drying, a dry paper towel should be used to turn off the water (and open any exit door if necessary).
| + | *Cottage cheese |
| | + | *Fish cooked soft |
| | + | *Meat loaf, meatballs, cottage pie, and other soft dishes with ground meat |
| | + | *Scrambled eggs |
| | + | *Tofu |
| | + | *Yogurt\ |
| | | | |
| − | To 'scrub' one's hands for a [[surgery|surgical operation]], a tap that can be turned on and off without touching with the hands, some [[chlorhexidine]] or [[povidone-iodine|iodine]] wash, sterile towels for drying the hands after washing, and a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails are required. All jewellery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with a sterile cloth and a surgical gown is donned.
| + | == Fruits and vegetables == |
| | | | |
| − | In the late 1990s and early part of the 21st century, [[Alcohol rub|non-water-based hand hygiene agents]] (also known as alcohol-based hand rubs, antiseptic hand rubs, or hand sanitizers) began to gain popularity. Most are based on [[isopropyl alcohol]] or [[ethanol]] formulated together with a [[thickening agent]] such as [[Carbomer]], and a [[humectant]] such as [[glycerin]] into a gel, liquid, or foam for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on their ease of use, rapid killing activity against microorganisms, and lower tendency to induce irritant contact dermatitis as compared to soap and water hand washing. Despite their effectiveness, the non-water agents do not clean hands of organic material, they simply disinfect them. However, disinfection does prevent transmission of infectious microorganisms.
| + | *Applesauce |
| | + | *Avocados |
| | + | *Bananas |
| | + | *Carrots, broccoli, or other vegetables cooked soft or processed in the blender |
| | + | *Creamed spinach |
| | + | *Many kinds of [[soup]] |
| | + | *Peeled pears or peaches, ripe or canned |
| | | | |
| − | Visible soiling of any sort on the hands must be washed with soap and water because alcohol-based hand rubs are ineffective in the presence of organic material. In addition, alcohols are ineffective against non-lipid-enveloped viruses (e.g., Noroviruses) and the spores of bacteria (e.g., Clostridium difficile) and protozoa (e.g., Giardia lamblia). When such microorganisms are likely to be encountered, soap and water hand washing is preferable.
| + | == Desserts == |
| | | | |
| − | The [[New England Journal of Medicine]] reports that lack of hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients.<ref>{{cite journal |author=Goldmann D |title=System failure versus personal accountability--the case for clean hands |journal=N. Engl. J. Med. |volume=355 |issue=2 |pages=121–3 |year=2006 |pmid=16837675 |doi=10.1056/NEJMp068118}}</ref> One study has shown that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.<ref>{{cite journal |author=Pronovost P, Needham D, Berenholtz S, ''et al'' |title=An intervention to decrease catheter-related bloodstream infections in the ICU |journal=N. Engl. J. Med. |volume=355 |issue=26 |pages=2725–32 |year=2006 |pmid=17192537 |doi=10.1056/NEJMoa061115}}</ref>
| + | *Custard |
| − | | + | *Fruit [[smoothies]] |
| − | == Truths, myths, and misinformation ==
| + | *Ice cream |
| − | {{rewrite-section}}
| + | *[[Milkshakes]] |
| − | | + | *Pudding |
| − | ;Alcohol-free hand sanitizers are not as effective as alcohol hand rubs: ''This is misinformation''
| + | *Yogurt |
| − | | |
| − | The [[efficacy]] of alcohol-free hand sanitizers are heavily dependent on their [[ingredients]] and [[formulation]]. In the past, alcohol-free hand [[sanitizer]]s tended to significantly under-perform [[alcohol]] or [[alcohol rub]]s as germ killers in [[clinical studies]] using standard [[protocols]] such as EN1500. More recently, advanced [[formulation]]s have been developed, some of which have been shown to out-perform [[alcohol]]. A further aspect of [[efficacy]] that is sometimes overlooked is the effect of repeated use. The [[efficacy]] of [[alcohol]] as a hand [[disinfectant]] has been shown to decrease after repeated use, thought to be due to progressive adverse skin reactions, whereas the efficacy of an alcohol-free hand [[sanitizer]] based on [[Benzalkonium Chloride]] as its [[active ingredient]] has been shown to increase with repeated use. <ref>AORN; Dyer, etal; Aug 1998; VOL 68, No2;http://www.aornjournal.org/article/abstracts?terms1=&terms2=&terms3= </ref>
| |
| − | | |
| − | ; Washing your hands with soap and water kills germs:''This is misinformation''
| |
| − | | |
| − | Plain [[soap]]s have minimal if any [[antimicrobial]] activity. In several [[clinical studies]], hand washing with plain soap failed to remove bad microorganisms ([[pathogens]]) from the hands of hospital personnel. Hand washing with plain soap can result in an increase in bacterial counts on the skin. Occasionally, contaminated plain soaps have colonized hands with [[Gram-negative bacteria]].<ref name="hhforhw">{{cite web| url = http://www.learnwell.org//handhygiene.htm |title = Hand Hygiene for Healthcare Workers | accessdate = 2007-04-27| publisher = LearnWell Resources, Inc, a California nonprofit public benefit 501(c)(3) corporation}}</ref>
| |
| − | | |
| − | ;Killing germs on your hands decreases your immunity:''This is a myth''
| |
| − | | |
| − | The [[skin]] on your body is covered with microorganisms. Our environment is contaminated with good and bad microorganisms. You cannot kill all of the microorganisms on your hands. Your [[large intestine]] contains large numbers of microorganisms. All of these sources of germs stimulate your [[immune response]]. [[Centers for Disease Control and Prevention|CDC]] guidelines for health care workers call for [[alcohol rub]]s to be used 60 or more times a day between patients and after touching contaminated surfaces. Killing germs on your hands will not decrease your immunity but it will help prevent disease.<ref name="hhforhw"/>
| |
| − | | |
| − | ;Alcohol rub hand sanitizers do not kill germs:''This is misinformation''
| |
| − | | |
| − | Hand sanitizers containing a minimum of 60 to 95% [[alcohol]] are very efficient germ killers. Alcohol rub sanitizers kill bacteria, multi-drug resistant bacteria ([[MRSA]] and [[VRE]]), [[tuberculosis]], and [[viruses]] (including [[HIV]], [[herpes]], [[RSV]], [[rhinovirus]], [[vaccinia]], [[influenza]], and [[hepatitis]]) and [[fungus]]. Alcohol rub sanitizers containing 70% alcohol kill 3.5 log<sub>10</sub> (99.9%) of the bacteria on hands 30 seconds after application and 4 to 5 log<sub>10</sub> (99.99 to 99.999%) of the bacteria on hands 1 minute after application. Alcohol rub sanitizers can prevent the transfer of health-care associated pathogens ([[Gram-negative bacteria]]) better than soap and water. Alcohol rub sanitizers are not appropriate for use when your hands are visibly dirty, soiled or contaminated with blood. Use soap and water for dirty or soiled hands.<ref name="hhforhw"/>
| |
| − | | |
| − | ;Don’t kill the good germs — the good germs protect our hands from the bad germs:''This is a myth''
| |
| − | | |
| − | Good germs are microorganisms normally found on human skin and bad germs are [[pathogenic]] (disease producing) microorganisms. The numbers of good germs and bad germs on the hands are variable from one person to the next but remain relatively constant for each individual. Good germs cannot protect you against bad germs. Anyone can become contaminated with bad germs (pathogens). Bad germs (pathogens) do not always cause disease and good germs can, under the right conditions, cause disease.<ref>{{cite journal |author=Schaberg DR, Culver DH, Gaynes RP |title=Major trends in the microbial etiology of nosocomial infection |journal=Am. J. Med. |volume=91 |issue=3B |pages=72S–75S |year=1991 |pmid=1928195|doi=10.1016/0002-9343(91)90346-Y}}</ref><ref>{{cite journal |author=Richet H, Hubert B, Nitemberg G, ''et al'' |title=Prospective multicenter study of vascular-catheter-related complications and risk factors for positive central-catheter cultures in intensive care unit patients |journal=J. Clin. Microbiol. |volume=28 |issue=11 |pages=2520–5 |year=1990 |pmid=2254429 |doi=}}</ref>
| |
| − | | |
| − | ;Alcohol will dissolve the natural oils on your skin and cause dry skin:''This is true''
| |
| − | | |
| − | Frequent use of alcohol-based formulations for hand sanitizers can cause [[dry skin]] unless [[emollient]]s and/or skin [[moisturizer]]s are added to the formula. The drying effect of alcohol can be reduced or eliminated by adding [[glycerin]] and/or other emollients to the formula. In several prospective clinical trials, alcohol based hand sanitizers containing emollients caused substantially less skin irritation and dryness than soaps or antimicrobial [[detergents]]. [[Allergic contact dermatitis]], contact [[urticaria]] syndrome or hypersensitivity to alcohol or additives present in alcohol hand rubs rarely occurs.<ref name="hhforhw"/><ref name="act_safe_as_ag"/>
| |
| − | | |
| − | ;Alcohol rubs cause (bacterial) mutation and resistance:''This is misinformation''
| |
| − | | |
| − | Dead microorganisms don’t [[mutate]]. Alcohol rubs (biocides) kill microorganisms. Current scientific evidence has not shown a link exists between the use of topical antimicrobial formulations and [[antiseptic]] or [[antibiotic]] resistance. Antiseptics (biocides) have multiple (thousands) of nonspecific killing sites on and in the microbial cell which cannot easily mutate. Antibiotics and antibacterial soaps ([[triclosan]]) have one very specific killing site on and in the microbial cell which can easily mutate. Antibiotic resistance has no effect on the effectiveness of antiseptics.<ref>{{cite journal |author=Jones RD |title=Bacterial resistance and topical antimicrobial wash products |journal=Am J Infect Control |volume=27 |issue=4 |pages=351–63 |year=1999 |pmid=10433675|doi=10.1016/S0196-6553(99)70056-8}}</ref><ref>{{cite journal |author=Barry AL, Fuchs PC, Brown SD |title=Lack of effect of antibiotic resistance on susceptibility of microorganisms to chlorhexidine gluconate or povidone iodine |journal=Eur. J. Clin. Microbiol. Infect. Dis. |volume=18 |issue=12 |pages=920–1 |year=1999 |pmid=10691210|doi=10.1007/s100960050434}}</ref>
| |
| − | | |
| − | ;Alcohol rub and combination hand sanitizers kill germs better than soap and water:''This is true''
| |
| − | | |
| − | Alcohol rubs and combination hand sanitizers are effective at killing germs on your hands, but not effective at removing dirt. Conversely, soap and water are very effective at cleaning dirty or soiled hands, but are not good at killing germs (as discussed above).<ref>{{cite web| url = http://www.cec.health.nsw.gov.au/pdf/AlcoholHandRub061013.pdf| title = Alcohol Hand Rub and Hand Hygiene | accessdate=2007-04-27 | publisher= Clinical Excellence Commission, Health, New South Wales, Australia }}</ref>
| |
| − | | |
| − | ;Alcohol rubs with two germ killers are significantly more effective germ killers than alcohol rubs with one germ killer:''This is true''
| |
| − | | |
| − | Many clinical studies have shown that alcohol rubs containing two germ killers (ie. Alcohol and [[Chlorhexidine gluconate]] or [[Benzalkonium chloride]]) are significantly better germ killers than alcohol rubs containing alcohol alone.<ref name="act_safe_as_ag">{{cite journal |author=Hibbard JS |title=Analyses comparing the antimicrobial activity and safety of current antiseptic agents: a review |journal=J Infus Nurs |volume=28 |issue=3 |pages=194–207 |year=2005 |pmid=15912075|doi=10.1097/00129804-200505000-00008}}</ref>
| |
| − | | |
| − | ==Hand washing as compensation==
| |
| − | | |
| − | Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
| |
| − | | |
| − | It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.<ref>Benedict Carey. [http://www.nytimes.com/2006/09/12/health/psychology/12macbeth.html Lady Macbeth Not Alone in Her Quest for Spotlessness.] ''[[The New York Times]]'', 12 September 2006</ref><ref>{{cite journal |author=Zhong CB, Liljenquist K |title=Washing away your sins: threatened morality and physical cleansing |journal=Science |volume=313 |issue=5792 |pages=1451–2 |year=2006 |pmid=16960010 |doi=10.1126/science.1130726}}</ref>
| |
| − | | |
| − | ==Symbolic hand washing==
| |
| − | [[Image:Tsukubai2.JPG|Tsukubai|thumb|[[Tsukubai]], provided at a Japanese temple for symbolic hand washing and mouth rinsing]]
| |
| − | [[Ritual purification|Ritual handwashing]] is a feature of many religions, including [[Bahá'í Faith]], [[Hinduism]] and [[Ablution in Judaism|tevilah and netilat yadayim]] in [[Judaism]]. Similar to these are the practises of [[Lavabo]] in [[Christianity]], [[Wudu]] in [[Islam]] and [[Misogi]] in [[Shintō]]. | |
| − | | |
| − | == Idioms ==
| |
| − | | |
| − | When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it. [[Gospel of Matthew|Matthew]] 27:24 gives an account of [[Pontius Pilate]] washing his hands of the decision to crucify [[Jesus]]: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."
| |
| − | | |
| − | In [[Shakespeare]]'s [[Macbeth]], [[Lady Macbeth (Shakespeare)|Lady Macbeth]] begins to compulsively wash her hands in an attempt to cleanse an imagined stain, representing her guilty conscience regarding crimes she had committed and led her husband to commit.
| |
| | | | |
| | == See also == | | == See also == |
| | | | |
| − | * [[Antibacterial soap]] | + | *[http://www.nidcd.nih.gov/health/voice/dysph.asp NIDCD information on dysphagia] |
| − | * [[Escherichia coli O157:H7|E. coli O157:H7]] | + | *[http://dysphagiaonline.com Dysphagia Online] |
| − | * [[Antibiotic resistance]]
| + | *[http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=53 British Dental Health Foundation] |
| − | * [[Ignaz Semmelweis]]
| |
| − | * [[Soap dispenser]]
| |
| − | | |
| − | == References ==
| |
| − | | |
| − | {{reflist|2}}
| |
| − | | |
| − | == External links ==
| |
| − | * [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings] | |
| | | | |
| − | [[Category:Hygiene]]
| |
| − | [[Category:Medical hygiene]]
| |
| | | | |
| − | [[de:Händedesinfektion]] | + | [[Category:Nutrition]] |
| − | [[fr:Hygiène des mains]] | + | [[Category:Diets]] |
| − | [[mn:Гар угаалт]]
| |
| − | [[ja:手洗い]]
| |
| − | [[simple:Hand washing]]
| |
| − | [[sv:Handtvagning]]
| |
