Healthcare’s Dirty Little Secret is in the Palm of Your Hands

Every doorknob, light switch, countertop, and trash can in your urgent care is a haven for flu-carrying, sniffle-causing, disease-spreading germs. But if you don’t insist on the highest standards for hand hygiene, all the cleaning in the world won’t stop germs from spreading from patient to patient, and to your staff.

The most common mode of pathogen transmission is the hands. But according to the Centers for Disease Control and Prevention (CDC), healthcare professionals clean their hands less than half of the times they should. The offenders give a variety of reasons including:

• Empty soap/hand sanitizer, paper towel dispensers
• Inconvenient location
• Dries out skin
• Forgetting during busy times
• Don’t have time because understaffed
• Putting patient needs first
• Don’t know or understand the guidelines and risks
• Disagreement with the guidelines

There are simple solutions to most of the problems listed above. Check dispensers regularly to be sure they’re full, especially when clinic visit volume is high. Place dispensers in handy locations, and provide pocket-sized bottles of hand sanitizer for use on-the-go. Provide hand lotions that don’t reduce the efficacy of cleaning products to reduce skin irritation. And be sure you’re adequately staffed so caregivers don’t have to choose between patient needs and clean hands.

Finally, education is essential for every person on your staff, even those who haven’t fully bought into the importance of clean hands. Be sure everyone knows the right way to keep their hands clean, and make hand hygiene a clinic priority.

Taking a hard line on handwashing is the single most important factor for preventing the spread of pathogens and antibiotic resistance in the healthcare setting. Hand washing and cleaning must be done by your staff often and correctly to reduce the bacterial count and be effective.

Hand Hygiene Options:

In an urgent care setting, there are three common hand sanitizing options.

1. Soap and water
2. Soap and water with antiseptic agent
3. Alcohol-based hand rub (60% alcohol)

According to the CDC, alcohol-based hand rubs are the most effective for preventing the spread of pathogens. Antimicrobial soap comes in second, and plain soap and water is third. All three options can be effective, but only if used properly.

Handwashing Guidelines:

Figuring out how and how often hands must be sanitized can be one of the biggest challenges to overcome. Staff may need to clean their hands as many as 100 times in a 12-hour shift.

• When visibly dirty or contaminated, hands should be washed with soap and water. For best results, hands should be rubbed together with soap for a minimum of 15 seconds, making sure to cover all surfaces, before rinsing with water. A paper towel should be used to dry—and to turn off the faucet. Long or artificial nails can be a hot spot for germs. A good rule of thumb is to keep nails trimmed to a quarter-inch tip, and restrict artificial nails with high-risk patients.
• Staff can use an alcohol-based hand rub or sanitizer for routine decontamination when hands aren’t visibly dirty. As with soap and water, be sure the sanitizer covers all surfaces. Hands should be rubbed together and remain wet for a minimum of 20 seconds. Using a sanitizer is a time-saver and doesn’t require the availability of water making it a great choice for flu season when visit volume is generally at its peak.

When to Wash:

Hands can’t be too clean, so the only real downside to washing too much is minor skin irritation. For those who suffer with severe skin irritation, the availability of emollient lotions is a must. Generally speaking, these simple rules should help figure out how often and when to wash hands.

Before: patient contact, donning gloves, inserting a catheter, inserting any invasive device that doesn’t require surgery, preparing food or eating lunch

After: contact with patient’s skin, contact with body fluids or excretion, contact with wound dressings, removing gloves, bathroom breaks, removing garbage, sneezing or blowing nose, excessive coughing

With the flu season in full swing, it’s a great time to remind everyone at your urgent care about the importance of this simple and effective, disease-preventing practice. It should be your first line of defense for keeping your patients—and your staff—healthier, all year long.

Source: The U.S Department of Health and Human Services.