Hand Hygiene

by Thomas Sandora, MD, MPH, Children's Hospital Boston

Q: Why is hand hygiene important?
A: Germs can make you sick. And being sick is no fun. It often means missing school, work or other planned activities.

Most people don't realize that four out of five germs that cause illness are spread by hands. So good hand hygiene is extremely important for the whole family. According to the Centers for Disease Control and Prevention (CDC), hand hygiene is the single most important means of preventing the spread of infection.

Q: What causes colds and stomach flus?
A: Colds and stomach flus can be caused by viruses or bacteria, which are each a kind of germ. Even though many people believe so, things like cold weather and not getting enough sleep do not actually cause infections or colds or stomach flu.

Q: How can stomach flus be spread?
A: Stomach flus are also spread by the hands. Sharing food, shaking hands or touching objects that a sick person has touched can all spread a stomach flu from one person to another.

Q: How can colds be spread?
A: Many people know that if a sick person talks closely (within three feet) or coughs on someone, a cold can be spread. What people often don't realize is that a more important way that colds spread is by the hands. Shaking hands with a sick person or touching the same objects he's touched can spread his cold. This is why keeping your hands clean is so important in preventing the spread of colds.

Q: How can I practice hand hygiene to help prevent the spread of colds and flus?
A: There are two ways to practice hand hygiene:

Q: Why are hand sanitizers a good option?
A: Hand sanitizers are a convenient way to get rid of germs when hands are not visibly soiled. Because water, soap or towels are not needed, hand sanitizers can be taken with you and used any time, any place.

For example, hand sanitizers can be carried in your purse, backpack and in the car. And of course, they can be kept throughout the home or office -- giving you and your family a convenient way to get rid of the germs on your hands.

Q: How much alcohol-based hand sanitizer should I use when I clean my hands?
A: The correct amount to use is a nickel-sized amount (or about the size of your thumbnail).

Q: How long should I rub my hands together when using hand sanitizer?
A: You should rub your hands together until they are dry, no matter how many seconds it takes. Once the sanitizer is completely rubbed in, it will kill the germs on your hands.

Q: How long should I wash my hands with soap and water to adequately clean them?
A: Most experts agree that you should wash your hands for at least 15 seconds. This may seem like a long time, but shorter washings may not remove enough germs to prevent infections from spreading.

Q: Don't alcohol-based hand sanitizers make your hands dry?
A: Many studies have shown that alcohol-based hand sanitizers cause less dryness and irritation to hands than frequently washing with soap and water.

Q: Can alcohol-based hand sanitizers make bacteria more resistant to antibiotics?
A: No. Many people have heard about this problem with antibacterial products, which contain antibiotics and can contribute to making bacteria resistant. One advantage of alcohol-based hand sanitizers is that they do not contain antibiotics, so they will not make bacteria more resistant!

Q: When should I practice hand hygiene?


Hand Hygiene Instructions:
Alcohol-Based Hand SanitizingSoap & Water
1. Put a thumbnail-size amount in your palm (enough to thoroughly cover your hands).
2. Rub your hands together briskly until dry.
3. Be sure to get the backs of hands and between fingers.
4. No rinsing or towels required.

**NOTE: If your hands are visibly dirty or soiled, wash them with soap and water at the sink instead.

1. Turn water on to a comfortable warm temperature.
2. Wet your hands and wrists.
3. Rub your hands with soap. Work soap into a rich lather.
4. Be sure to get the backs of hands and between fingers.
5. Wash for at least 15 seconds.
6. Rinse completely with running water.
7. Dry hands with a clean towel.

Thomas J. Sandora, MD, MPH, is an assistant in medicine in the Infectious Diseases Department at Children's Hospital Boston. His particular areas of interest include hospital epidemiology, infection control and hand hygiene. He also conducts research in medical education.
For more information about Children's Hospital Boston, please visit our website at: https://www.childrenshospital.org/.


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