Health-care workers have new hand-washing guidelines. Here's how you can apply them

Beyond the usual soap, water and paper towel treatment, hand hygiene has typically been the domain of health-care professionals and food and beverage workers.

However, the COVID-19 pandemic served as a reminder for households around the world about the importance of thorough, multi-step hand washing. The way respiratory viruses have circulated this winter following the return to in-person learning and pre-pandemic social activities, most Canadians could probably benefit from a refresher.

Fortunately, the standard essential practices for hand hygiene in health-care settings have just received an update, thanks to a collaboration between five major U.S.-based medical organizations.

The latest recommendations – entitled "Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update" – emphasize the importance of healthy skin and nails and easy access to alcohol-based hand sanitizers for preventing the spread of infectious germs.

Here are some of the current guidelines anyone can apply in their daily life.

CONSIDER YOUR FINGERNAILS

Short, natural nails with standard polish or no polish are easier to clean than long nails, artificial nails, and nails painted with gel shellac, according to the guidelines. They're also less likely to harbour harmful germs.

Dr. Emily Sickbert-Bennett is one of the authors of the latest guidelines, and works as director of hospital epidemiology at the University of North Carolina Hospitals.

She said that while the recommendations around fingernails apply specifically to health-care settings, where bacterial and viral outbreaks are a serious concern, anyone working with potential contaminants at home should also make sure to clean the underside of their nails.

"So if you are…say, handling raw chicken or touching the inside of a raw turkey, that is, an activity that can contaminate your hands," she told CTVNews.ca in a phone interview on Wednesday. "And of course, you want to be sure that you can clean all the surfaces, including up and under the fingernails where there could be some contamination."

REMEMBER THUMBS AND FINGERTIPS

It's easy to cut corners while handwashing, even for health-care professionals. According to the authors of the updated guidelines, existing research had shown only seven per cent of health-care personnel effectively clean the entire surface of their hands.

Thumbs and fingertips are the areas of the hand people most frequently miss. So the next time you wash your hands, pay extra attention to your thumbs and fingertips. The Public Health Agency of Canada recommends rubbing wet, soapy hands together for at least 20 seconds before rinsing and drying with clean paper towel. If soap and water aren’t available, use a hand sanitizer containing at least 60 per cent alcohol and rub your hands together until dry.

NURTURE YOUR SKIN AND NAILS

According to the authors, maintaining healthy skin and nails is a crucial element of hand hygiene.

Cracked, damaged and otherwise injured skin on the hand can become a haven for harmful pathogens, according to the World Health Organization, which writes in its own hand hygiene guidelines, "skin damage may lead to bacteria colonizing the skin and possible spread of blood-borne viruses as well as other microorganisms."

Sickbert-Bennett said people are also less inclined to follow proper, thorough hand-washing techniques when their hands are dry and painfully cracked. This, she said, is where the guidelines around healthy skin and nails really apply to the average person.

"The types of organisms we're talking about, they are unlikely to cause disease in a home setting among healthy people," she said.

"I'd say that the more relatable piece of this to the home setting…is that as your skin breaks down, it's very irritated, and then makes it difficult and painful for you to continue to wash your hands. So it is really important to keep moisture on them to keep your skin healthy." 

The updated hand hygiene guidelines recommend maintaining the health of your skin and nails by making sure you have access to hand sanitizer and moisturizer, avoiding washing with overly hot water, and patting, rather than rubbing, your hands dry.  

BE CONSISTENT

Of all the new and old guidelines for hand hygiene in health-care settings, Sickbert-Bennett said there is one that is particularly important in households: make sure everyone is doing it. In some households, this might involve coming up with creative ways to turn hand washing into a routine before and after using the washroom, preparing food or eating.

"I think the thing that really matters the most when it comes to hand hygiene is doing it…and sort of developing the habit to do it each time when it's really important," she said.

"To me, this sort of boils down to, how to ingrain habits in your household among your family; even simple things like saying out loud before meals, 'Let's all wash our hands before we eat,' and getting into routines and habits."