1.2: Effectiveness of Handwashing

Learning Objectives

• Discuss the importance of proper handwashing.
• Compete the Effectiveness of Handwashing Activity. 

 

The Importance of Handwashing

Handwashing prevents the spread of potentially infectious microbes. It is key to maintaining public health and should be prioritized in laboratory research, clinical settings, and every-day activities. Microbes can easily spread from:

• Direct contact with surfaces, biological samples, and other microbe covered objects.
• Improper preparation and handling of food.
• Touching your face with unwashed hands.
• Sneezing or coughing in public settings and not covering these actions.

 

Figure 1. The CDC suggests the following 5 step handwashing process. It is important to wash your fingers, palm, and wrists with a soap lather for at least 20 seconds. Hands should be dried with paper or clean reusable towels. Use a towel to turn the sink off, don't touch the sink with your hand or you risk re-introducing foreign microbes! 

 

Washing your hands often will help prevent microbial transmission. Proper handwashing includes: scrubbing your hands with soap for at least 20 seconds, rinsing hands under clean water, and using towels to dry your hands fully before turning off the sink. (See Figure 1) If soap and water are not available, alcohol-based hand sanitizers containing at least 60% alcohol may be used. These types of hand sanitizers can help reduce the amount of microbes present, but they will not remove all microbial species and their effectiveness will vary depending on how greasy or dirty your hands are.

The CDC recommends washing your hands:

• When preparing and consuming food.
• After using the bathroom, changing diapers, cleaning an individual who was vomiting or had diarrhea, and any other time you come in to direct contact with human excretions. 
• After touching animals, animal feed, garbage, outdoor toys/shoes/etc., and other items that may easily accumulate microbes. 
• After you cough or sneeze. Never cough or sneeze into you hands. Always try to cough or sneeze into your elbow or a tissue. 

In addition to handwashing, gloves are key to decreasing microbial transmission. Gloves act as a physical, protective barrier that prevent contamination when working directly with biological agents. Changing your gloves often, washing you hands after removal, and wearing the correct size gloves will help decrease microbial transmission. How you remove your gloves is equally as important to wearing gloves. Improper glove removal increases the risk of coming in to contact with biological agents. To safely remove your gloves:

1. When both hands are covered in gloves, first pinch the outside of one glove near your wrist. Do not touch your uncovered skin.
2. Where you have pinched the glove, start to peel it up your hand, turning the glove inside out until it is off your hand.
3. Peel the second glove off by inserting your fingers at the wrist and underneath the remaining glove. Turn the glove inside out until it is off your hands. 
4. Replace gloves that: are damaged, contaminated with biological agents, or contaminated with chemical reagents. 

Real-World Connections

Clostridioides difficile

Washing your hands, using alcohol-based sanitizer, or using surgical-grade antisepsis are basic steps in maintaining hand hygiene. Hand hygiene is the number one most important step to preventing HAIs. Healthcare workers have reported washing their hands up to 100 times per shift to maintain a sterile environment. (Openstax, 2024) Washing your hands with soap and water is the best method for removing microbes. Select microbial species can not be removed using only sanitizers, such as Clostridioides difficile.

Clostridioides difficile, better known as C. diff, is a gram positive bacterium that causes severe colitis and diarrhea. If left untreated, C. diff can lead to death. The CDC estimates that there are half a million C. diff infections in America each year. 1 in 6 of these patients will contract the bacteria again 2 to 8 weeks after the initial infection. (CDC, 2024) C. diff is very common in nursing facilities, hospitals, and other healthcare settings. The bacteria is spread in stool from person to person, but it can live on a person’s skin.

A patient with C. diff present on their skin’s surface can spread the bacteria through direct contact. Since alcohol-based sanitizers cannot kill the bacteria, the only way to remove them from the skin is using soap and water. Patients with C. diff or healthcare workers and family helping the patient should wash their hands every time they come into contact with the patient, whenever the bathroom is used, and every time food is prepared or eaten. Wearing gloves, taking showers, and washing clothes are also good ways to decrease the risk of transmission

Figure 2. The CDC suggests the following 7 steps be taken to safely remove gloves and decrease the risk of microbial transmission from the glove surface. 

Attributions

"The Introduction to Microbiology: Depth and Breadth of Microbiology" by Marisa Cases, "A remix of OpenStax: Microbiology", Manchester Community College is licensed under CC BY

"Keeping Hands Clean" by Centers for Disease Control and Prevention , Use of CDC Materials Statement is in the Public Domain

"CDC, Ebola: Personal Protective Equipment (PPE) Donning and Doffing Procedures" by Centers for Disease Control and Prevention , Use of CDC Materials Statement is in the Public Domain

"Fundamentals of Nursing Textbook: Chapter 10, Infection Control and Prevention" by Openstax, Digital ISBN: 13: 978-1-961584-41-9 is licensed under CC BY 4.0

"C. diff (Clostridioides difficile): About C. diff" by Centers for Disease Control and Prevention, Use of CDC Materials Statement is in the Public Domain

"C. diff (Clostridioides difficile): Preventing C. diff" by Centers for Disease Control and Prevention, Use of CDC Materials Statement is in the Public Domain

Image Citations 

Figure 1, "The Introduction to Microbiology: Depth and Breadth of Microbiology" by Marisa Cases, "A remix of OpenStax: Microbiology", Manchester Community College is licensed under CC BY 4.0

Figure 2, "CDC, Ebola: Posters and Fact sheets" by Centers for Disease Control and Prevention , Use of CDC Materials Statement is in the Public Domain

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