From the moment we are born, our hands become our primary tools for multitasking, and we rely on them for almost everything. But despite their usefulness, our hands are also the unwitting culprits behind the spread of germs and disease. As we touch many surfaces throughout the day, we can pick up and spread germs each time. The recent COVID-19 pandemic has highlighted just how easily these tiny pathogens can hitch a ride on our hands and wreak havoc on our health and daily lives. With the world still reeling from the effects of the deadly virus, it has become increasingly evident that the time to accelerate hand hygiene progress is now before another pandemic hits.
Going Back in History
The story of hand hygiene begins with Ignaz Semmelweis, a Hungarian doctor working at Vienna General Hospital in the mid-nineteenth century. He noticed a high mortality rate among women giving birth in a doctor-run maternity ward compared to the adjacent midwife-run ward. He attributed this to doctors carrying “cadaverous particles” on their hands from performing autopsies. So he postulated and realized going straight from an autopsy to the maternity ward was the reason behind the mortality, leading him to mandate handwashing with chlorine, reducing death rates. This was the first proof that cleaning hands could prevent infection, and he was known as the father of hand hygiene by then.
Later during the Crimean War, Florence Nightingale also became a pioneer of handwashing. She implemented hygiene practices in the war hospital where she worked, including frequent handwashing, and wrote about it in her 1860 publication “Notes on Nursing.”
“Every nurse should carefully wash her hands frequently during the day.”
However, it wasn’t until scientists like Pasteur and Koch discovered the role of microorganisms in diseases that hand washing became widely recognized as an essential practice in medicine. Surgeon Joseph Lister advocated for handwashing and instrument sterilization, drastically improving patient mortality rates. Today, hand hygiene is considered vital for medical professionals and patients alike, and our knowledge now results from the work of many researchers and developers.
Hand Hygiene: A Groundbreaking Development
Hand hygiene has always been critical to infection prevention and control. It is a ground-breaking development proven to combat infection and promote prevention and control. A simple yet effective practice that is within reach of everyone and its impact cannot be overstated. Whether you’re a healthcare worker or an ordinary citizen, the importance of hand hygiene cannot be ignored.
The World Health Organization has highlighted the importance of accelerating action to prevent infections and antimicrobial resistance in healthcare and building a culture of safety and quality in which hand hygiene improvement is prioritized. Sustainable Development Goal (SDG) 6 calls for the global community to achieve access to hygiene for all by 2030. Hence, Hand hygiene is one of the most critical elements.
Various studies have shown that progress on hand hygiene is periodically accelerated by high-profile disease outbreaks, including H1N1 influenza, Ebola viral disease, and, most recently, COVID-19. In response to COVID-19, healthcare facilities worldwide have promoted hand hygiene as a first line of defence in controlling the pandemic and increasing resilience to future disease outbreaks.
“It is estimated that half a million people die yearly from diarrhoea or acute respiratory infections that could have been prevented with good hand hygiene”
World Health Organisation
Hand Hygiene as the First Line of Defence
Resident flora are microorganisms that are typically found on the skin and are part of the normal skin flora, whereas transient flora is micro-organisms that are acquired by contact with other people or contaminated surfaces. Common pathogens such as MRSA, VRE, MDR-GNBs, Candida spp., and Clostridium Difficile can survive on hands and other surfaces for extended periods, making them particularly dangerous in healthcare settings where they can be easily transmitted from patient to patient if proper hand hygiene is not practiced. Hand hygiene is critical in preventing the spread of these pathogens and reducing the risk of healthcare-associated infections.
Hand Washing or Hand Sanitizing: Which is More Effective
Hand hygiene methods can be categorized into hand washing and hand sanitizing.
Hand washing involves using soap and water to clean the hands thoroughly. It is the most effective method of hand hygiene as it removes dirt, grime, and microorganisms from the hands. Hand washing should be done for at least 20 seconds, and all parts of the hands should be thoroughly washed, including the backs of the hands, fingers, and under the nails.
However,alcohol-based hand sanitizers effectively kill most germs and are preferred for maintaining hand hygiene. However, they may not be effective against specific pathogens like Clostridium difficile, which causes life-threatening diarrhoea, and other pathogens that may be resistant to alcohol. In such cases, hand washing with soap and water is recommended.
Hand washing and its Role for AMR
With the rise of multidrug-resistant organisms, effective hand hygiene practices have become more pressing. Studies have also shown that hand washing can prevent up to 20% of respiratory infections, which are often caused by viruses and do not require antibiotics. By practicing good hand hygiene, we can all do our part to help control the spread of infections and reduce the burden of AMR.
Hand hygiene, As a Component SICPs of NHS
SICPs, is the primary infection prevention and control measure necessary to reduce the risk of transmitting infectious agents from recognized and unrecognized sources of infection.
Conclusion:
“It is estimated that three out of ten people, 2.3 billion globally, lack a facility with water and soap available to wash their hands at home, including 670 million who have no handwashing facility at all.”
World Health Organisation
The “International Day of Hand Hygiene” on May 5 was initiated by the World Health Organization in 2009. Since then, the WHO campaign has emphasized hand disinfection as the most effective single measure to break the chain of infection. The theme of World Hand Hygiene Day 2023 is Accelerate action together, SAVE LIVES – Clean Your Hands. This theme emphasizes, “Together, we can accelerate action to prevent infections and antimicrobial resistance in health care and build a culture of safety and quality in which hand hygiene improvement is given high priority.”Hand hygiene is a ground-breaking development that has revolutionized how we prevent the spread of infectious diseases. The importance of hand hygiene has been recognized for centuries, and it continues to play a vital role in healthcare and public health. Regular hand washing and hand sanitizing are essential practices to prevent the spread of diseases, and it is up to each individual to make it a part of their daily routine.
References
- England, N. (n.d.-a). NHS England » Chapter 1: Standard infection control precautions (SICPs).
- News-Medical.net. (2022, April 14). How can Hand Hygiene Prevent the Spread of Disease? Hand hygiene: finding facts and debunking myths | Seton UK. (2022, May 4). Seton UK.
- Hand hygiene: finding facts and debunking myths | Seton UK. (2022, May 4). Seton UK.
- World Hand Hygiene Day 2023. (n.d.). https://www.who.int/campaigns/world-hand-hygiene-day/2023
- C. (2020, April 28). History of Hand Hygiene – Semmelweis Foundation. Semmelweis Foundation. https://semmelweis.info/history-of-hand-hygiene/