Hand Hygiene

Disease Control and Prevention Center
National Center for Global Health and Medicine(WHO Collaboration Center)

Shinichiro Morioka, M.D.

(WHO Guidelines on Hand Hygiene in Health Care: World Health Organization 2009)

WHO Guidelines on Hand Hygiene

As hands of healthcare professionals play animportant role in transmission of pathogens, handhygiene is an important infection control measure.

(WHO Guidelines on Hand Hygiene in Health Care: World Health Organization 2009)

(http://www.who.int/gpsc/5may/background/5moments/en/)(http://www.who.int/gpsc/5may/background/5moments/en/)(http://www.who.int/gpsc/5may/background/5moments/en/)Hand hygiene can decrease
nosocomial infections

1994

1997
Lancet 2000; 356: 1307-12.

(http://www.who.int/gpsc/5may/background/5moments/en/)Types of Hand Hygiene
Hand-washing with soap under running water✓ When hands are visibly contaminated (blood, body fluid, etc.)✓ When microorganisms that have resistance to alcohol (CD,Norovirus, etc.) are expected

Hand antisepsis with alcohol-based hand-rubs✓ Hands are not visibly contaminated, High effects of sterilization✓ Procedure of protecting skin with humectant is simple

Disinfecting effects of hand hygiene

Hand hygiene
techniqueSoap + running
water
Alcohol-based
handrub

Disinfecting effect
15 seconds

30 seconds

1/4-1/13

1/60-1/600
30 seconds

1/3,000

Boyce J.M., et al.：MMWR. Recommendations and Reports., 2002, 51（RR-16）, pp. 8-9
Takashi Okubo, Hiroyoshi Kobayashi (supervising translation)“CDC Guideline for Hand Hygiene in Health-Care Settings”,
2003, Medical Publishing, pp. 31-33
Infection Control Editorial Office “INFECTION CONTROL”, 2009 Spring Special Edition, p. 17 (partially modified)10

Before hand-washing

After hand-washing with soap
and running waterBefore handantisepsis

After handantisepsis

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm

Basic Measure of Infection Control is Hand Hygiene: Correct
Technique of Hand-Washing

Wet hand under
running water

Dispense soap
on the palm

Make a lather
with the soap

Wash well
between fingers

Wash fingers
well

Wash thumbclasped in the palmof other hand

Wash the wrists

Wash off under
running water

Tap with a paper
towel to wipe awaywater

National Center for Global
Health and Medicine

Wash with right palm
over left dorsum andvice versa

Wash fingertips
and nails well

Infection Control Committee

Basic Measure of Infection Control is Hand
Hygiene: Correct Technique of Hand-Washing

Dispense 1 push ofdisinfectants on thepalm

First, rub fingers ofboth hands

Then, rub hands
palm to palm

Rub palm to palm
with fingers
interlaced

Rub thumb clasped
in other palm

Remember to rubwrists until they
become dry

National Center for Global
Health and Medicine

Rub right palm overleft dorsum andvice versa

Infection Control Committee

Q&A
Even after touching the surroundings of a bed
in a patient’s room of a patient for whom noMRSA is detected, hand antisepsis is needed.

○ YES

NO

Regardless of whether or not a patient has aninfectious disease, standard preventive measures
including hand hygiene must be taken for all patients.

Q&A
When hands are visibly dirty, dohand-washing with soap under
running water.

○ YES

NO

When hands are not visibly dirty,
alcohol-based handrubs should beused.

Q&A
Hand hygiene is needed not only
before wearing gloves but also after
removing them.

○ YESNO

Because gloves are not perfect and they may havea pinhole, hand antisepsis is needed before
wearing and after removing gloves.

Reference• WHO Guidelines on Hand Hygiene in Health Care: World Health Organization
2009, (modified)
http://www.who.int/gpsc/5may/background/5moments/en/• Takashi Okubo, Hiroyoshi Kobayashi (supervising translation) “CDC Guideline
for Hand Hygiene in Health-Care Settings”, 2003, Medicus Shuppan Publishers• Guidelines for Infection Control in University Hospitals 2nd edition Edited by
Japan Infection Prevention and Control Conference for National and Public
University Hospitals, amended version, Jiho Inc., 2015
• Miho Uchida “Actual Practice of Infection Control” Ishiyaku Pub, Inc., 2012
• Educational Tool Ver. 3.2 of the Japanese Society for Infection Prevention andControl (partially modified)

Open discussion