Handwashing with soap is a simple, cost-effective practice that can prevent disease and save lives.
National Handwashing Awareness Week is held every year from December 1-7 to educate people about the importance of hand hygiene. Germs are everywhere - in food, on surfaces, plants and animals, in water and soil, on our body, and especially on our hands. Some germs are harmless, but others, as we are learning every day, can be deadly. Hand hygiene is the best way to prevent the spread of germs. The simple act of washing hands with soap and clean, running water is an easy and effective way to remove to remove germs from hands, prevent diseases, avoid spreading germs to others, and save lives. In 2020, National Handwashing Week is more significant than ever as the World Health Organization (WHO) says handwashing with soap remains our best defence against coronavirus.
How Handwashing helps reduce Risk of Disease
Infectious diseases can be spread from one person to another by contaminated hands. The hands harbour thousands of germs.
"There are more bacteria on your hands than anywhere else," says Dr. Terry Platchek of the Stanford School of Medicine.
Surfaces and objects collect bacteria, viruses and other microorganisms and can become a vector of transmission. You are probably picking up germs and viruses when you:
• Touch non-sterile surfaces or objects
• Touch a contaminated surface or object and then touch your eyes, nose, and mouth without washing your hands
• Don't wash your hands before preparing or eating food and drinks
• Cough or sneeze into hands and then touch other people's hands or common objects
The current COVID-19 pandemic has emphasized the critical role of hand hygiene in preventing disease transmission. SARS-CoV-2 is spread when an infected person coughs or sneezes and the infectious droplets land on another person or a frequently touched object or surface such as doorknobs, handrails and tables. The virus can also get transmitted through handshakes if the person carrying the virus sneezes or coughs into their hand. Washing hands with soap destroys the outer membrane of the virus and kills it.
If soap and water are not available, the CDC recommends using an alcohol-based hand sanitizer that contains at least 60 percent alcohol to kill the germs. The important difference between washing hands with soap and water and using hand sanitizer is that soap and water can eliminate all types of germs from hands, while sanitizer works to kill specific germs on the skin.
Impact of Hand Hygiene on Infectious Disease Risk
The Centers for Disease Control and Prevention (CDC) references various studies which show that teaching communities about handwashing can reduce:
• The number of people who get sick with diarrhea by 23-40%
• Diarrheal illness in people with weakened immune systems by 58%
• Respiratory illnesses, like colds, in the general population by 16-21%
• Absenteeism due to gastrointestinal illness in schoolchildren by 29-57%
Hand hygiene plays a key role in reducing the transmission of cholera, Ebola, shigellosis, SARS and hepatitis E, healthcare-associated infections, and Neglected Tropical Diseases Handwashing also reduces antimicrobial resistance. WHO notes that one study found that regular handwashing with soap can reduce the likelihood of COVID-19 infection by 36% (www.globalhandwashing.org
Guidance for Effective Handwashing
Besides understanding the risks of not washing hands, people also need to know when and how to handwash. Whether at home, in the office or in a public place, it's important to be mindful about what you touch and to wash your hands.
When to wash your hands:
• Before, during and after preparing food
• Between handling raw and cooked or ready-to-eat food
• Before eating
• After changing a child's diapers
• After blowing your nose, coughing, or sneezing
• Before and after attending to a wound
• After using the toilet and cleaning a child who has used the toilet
• After using a tissue or handkerchief
• Before and after attending to a sick person
• After smoking
• After touching animals
• After handling garbage
The correct method of washing hands:
While effective and frequent hand hygiene is the key to cutting risk of many diseases, unfortunately, many people don't perform handwashing properly. A 2013 Michigan State University study reported that 95 percent of people don't wash their hands correctly. The researchers found that while 15% of men and 7% of women did not wash their hands at all, 50% of men and 22% of women did not use soap.
The CDC refers to hand washing as "a do-it-yourself vaccine" and recommends five easy steps to do it: wet, lather, scrub, rinse, dry. The proper way to wash hands is to wet them, apply soap and lather up. Scrub all surfaces and under the fingernails for at least 20 seconds. Rinse the hands well and dry them thoroughly with a clean towel or air-dry them.
Is antibacterial soap better? No, say experts. Though antibacterial soaps contain ingredients like triclosan or triclocarban that can kill the bacteria, studies have found no evidence that antibacterial soaps are more effective than plain soap for removing germs and preventing infection.
Hand Hygiene Compliance in Healthcare Settings
Hand hygiene is a basic and important element of infection control activities. In healthcare settings, cross infection can be caused by human contact, coughing and sneezing, unsterilized medical equipment, handling contaminated objects, soiled bedding, and prolonged use of catheters, tubes, or intravenous lines.
Healthcare workers' hands have a crucial role in the transmission of pathogens within the healthcare environment and ultimately to patients. Microbes that can be spread via the hands of healthcare workers, as listed by WHO, include:
• Staphylococcus aureus (including MRSA)
• Streptococcus pyogenes (Group A Strep)
• Vancomycin-resistant Enterococcus (VRE)
• Clostridium difficile
• Hepatitis A virus
On any given day, about one in 31 hospital patients has at least one healthcare-associated infection (HAI), notes the CDC. Studies have found that, if properly implemented, hand hygiene alone can significantly reduce the risk of cross-transmission of infection in healthcare settings (www.who.int/patientsafety/en/
Healthcare workers should comply with hand hygiene rules while making contact with patients or their surroundings. However, according to the CDC, on average, healthcare providers clean their hands less than half of the times they should. To protect themselves and their patients from infections, healthcare providers should clean their hands before and after every patient contact. In healthcare settings, the CDC recommends an alcohol-based hand rub (ABHR) with 60-95% alcohol over soap and water in most clinical situations.
Healthcare workers are the frontline fighters of COVID-19 and they are constantly exposed to the virus via infected patients and contaminated surfaces. Hand hygiene is of utmost importance for the prevention of COVID-19 among healthcare staff.
National Handwashing Awareness Week is a wake-up call to take handwashing seriously and make it a habit. COVID-19 has certainly increased people's awareness about the role of handwashing in promoting hygiene and germ control. As people return to regular public activities, all facilities should be properly equipped to support handwashing with soap - a simple, cost-effective practice that can prevent disease and save lives.
Meghann Drella, CPC
is a Senior Solutions Manager at Managed Outsource Solutions (MOS), and is responsible for practice and revenue cycle management in the Healthcare Division. She has a formal education in Medical Coding and Billing and over 12 years of hands on experience in the field. She holds a CPC certification with the American Academy of Professional Coders (AAPC). Meghann has a strong understanding of ICD-10-CM and CPT requirements and procedures, and regularly attends continuing education classes to stay up to date with any changes. www.managedoutsource.com