AY Honors/Home Nursing/Answer Key

Schoolchildren washing their hands before eating lunch.

Hand washing is the act of cleansing the hands with water or other liquid, with or without the use of soap or other detergents, for the purpose of removing soil or microorganisms.

Purpose

The main purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field. Washing your hands is one of the most effective ways to maintain health and prevent infection. Template:Fact

While hot water may more effectively clean your hands, this is primarily due to its increased capability as a solvent, and not due to hot water actually killing germs. Hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill micro organisms. A temperature that is comfortable for hand washing (about 45 °C) is not nearly hot enough to kill any micro organism. It would take more than double that temperature to effectively kill germs (100 °C, which is boiling).

Personal hand washing

To maintain good hygiene, hands should always be washed after using the toilet, changing a diaper or tending to someone who is sick; before eating; before handling or cooking food and after handling raw meat, fish or poultry. 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. After drying a dry paper towel should be used to turn off water and open exit door. 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.

Antibacterial soaps 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. However, antibacterial soaps contain common antibiotics 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.

Medical hand washing

The purpose of hand washing in the health care setting is to remove or destroy (disinfect) pathogenic microrganisms ("germs" in common parlance) to avoid transmitting them to a patient. Water alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill pathogens. Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required (e.g. surgery).

The proper washing of hands in a medical setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically. 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 water and open exit door.

To 'scrub' one's hands for a surgical operation, one requires a tap that can be turned on and off without touching with the hands, some chlorhexidine or iodine wash, sterile towels for drying the hands after washing, a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. 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 the sterile cloth and the surgical gown is donned.

In the late 1990s and early part of the 21st century, non-water-based hand hygiene agents began to gain popularity. Most are based on isopropyl alcohol formulated into a gel or lotion for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on speed and ease of use it is easier to do a good job quickly with these agents than with soap and water. However, soap and water are as good as the non-water-based agents when used properly.

Despite their effectiveness, the non-water agents do not clean hands, they simply disinfect them. Visible soiling of any sort on the hands must be washed with soap and water. Alcohol-based disinfectants are similarly ineffective in the presence of large, visible amounts of extraneous material.

The New England Journal of Medicine reports that 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. One study has shown that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.[1]

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.

Symbolic hand washing

Tsukubai, provided at a Japanese temple for symbolic hand washing and mouth rinsing

• Ablution in the Bahá'í Faith
• Ablution in the Hebrew Bible
• Ablution in Hinduism
• Ablution in Judaism
• Lavabo in Christianity
• Misogi in Shintoism
• Wudu in Islam

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. 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."

See also

• E. coli O157:H7
• Antibiotic resistance
• Ignaz Semmelweis
• Soap dispenser

External links

• Alliance for Prudent Use of Antibiotics on hand washing
• Centers for Disease Control on hand hygiene in healthcare settings
• Hand Washing Video - Grey Bruce Health Unit, Canada