Table of Contents

The Rationale for Hand Hygiene

Hand Hygiene Procedures

Standards & Guidelines

Education & Teaching Aids

Posters & Videos

Other Information

WHO: Save Lives -Clean Your Hands

Healthcare Excellence Canada (formerly Canadian Patient Safety Institute): Clean Your Hands Day

CDC: Clean Hands Save Lives & Global Handwashing Day

Information about Hand Hygiene

WHO SAVE LIVES: Clean Your Hands

SAVE LIVES: Clean Your Hands brings people together in support of hand hygiene improvement
globally and to progress the goal of maintaining a global profile on hand hygiene in health care.

The campaign aims to galvanize action at the point of care to demonstrate that hand hygiene is the
entrance door for reducing health care-associated infection and patient safety. It also aims to
demonstrate the world's commitment to this priority area of health care.

WHO's role includes encouraging engagement and action to maintain this global movement.
Numbers are a great awareness-raising mechanism, as demonstrated by the growing number of
health-care facilities registered for SAVE LIVES: Clean Your Hands but they are not the end point.
Sustaining the efforts to improve patient safety requires dedicated action and innovation both of
which are now more crucial than ever. WHO have appreciated receiving communications about
country and health-care facility activities. Action must continue; use the WHO tools to support your
actions.

Join the WHO campaign

WHO Implementation Tools
WHO Hand Hygiene Tools and Resources

Healthcare Excellence Canada

Clean Your Hands Day: May 5, 2021

#CleanYourHandsDay

For Clean Your Hands Day this May 5, we want to thank everyone who’s making a difference by
following public health measures, including cleaning their hands.

We’ve cleaned our hands, stayed home, provided care, worn masks, practised physical distancing
and now we’re getting vaccinated too. Together, our efforts have saved lives, protected those who
are vulnerable and supported friends, families and neighbours in our communities.

Whether you’re a member of the public, patient, visitor, essential care partner, provider or work in a
healthcare setting, maintaining good hand and respiratory hygiene are very important personal
practices that help reduce the risk of infection or spreading infection to others.
This May 5 and every day, join us in celebrating everyone who is making a difference by
following local public health guidance.

Participate in the Clean Your Hands Day campaign

Share on social media to help spread the message of the importance of hand hygiene
and following all other public health measures
Share the Clean Your Hands Day newsletter article with your stakeholders

Communications Toolkit
Free digital downloads

Access and share hand hygiene resources to keep yourself and others safe

Hand Hygiene Resources

Make clean hands your habit – it protects all of us

The Rationale for Hand Hygiene

IPAC Canada IPAC Canada

Cleaning Hands Cleaning Hands
(English) (French)

Français

Why is hand hygiene important?

Hand hygiene refers to removing or killing microorganisms (germs) on the hands. When performed
correctly, hand hygiene is the single most effective way to prevent the spread of communicable
diseases and infections. In health care, hand hygiene is used to eliminate transient microorganisms
that have been picked up via contact with patients, contaminated equipment or the environment.
Hand hygiene may be performed either by using soap and running water, or with alcohol-based
hand rubs.

When should hand hygiene be performed?

In health care, hand hygiene is required:

Before and after contact with any patient/resident, their body substances or items
contaminated by them
Between different procedures on the same patient/resident
Before and after performing invasive procedures
Before preparing, handling, serving or eating food or feeding a patient/resident
After assisting patients/residents with personal care (e.g. assisting patient to blow nose,
toileting or doing wound care)
Before putting on and after taking off gloves
After performing personal functions (e.g. using the toilet, blowing your nose)
When hands come into contact with secretions, excretions, blood and body fluids (use soap
and running water whenever hands are visibly soiled)

When should soap and water be used?

The mechanical action of washing, rinsing and drying removes transient bacteria present on the
hands. Hand washing with soap and running water must be performed whenever hands are visibly
soiled.

Any type of plain soap may be used. However, bar soaps are not acceptable in health care settings
except for single patient/resident personal use. If used, bar soap should be kept in a self draining
holder that is cleaned thoroughly before new bars are put out. Liquid soap containers should be
used until empty and then discarded. Soap containers must not be topped up, as there is a risk of
contamination of residual soap. Antibacterial soaps may be used in critical care areas such as ICU,
or in other areas where invasive procedures are performed.

When should alcohol-based hand rubs be used?

Alcohol-based hand rubs/gels/rinses are the preferred method for decontaminating hands, provided
they contain more than 60% alcohol. They are widely used in health care settings, or in situations
where running water is not available. Using alcohol-based hand rub is better than washing hands
(even with an antibacterial soap) when hands are not visibly soiled.
Won't frequent hand hygiene dry my skin?

Intact skin is the first line of defence against microorganisms, hence it is important to maintain good
skin care. To prevent chafing, wet your hands before applying soap and use a mild lotion soap with
warm water; pat rather than rub hands dry; and apply lotion liberally and frequently. Skin lotions
should be chosen that will not interfere with glove integrity.

Most alcohol-based hand rubs contain emollients to reduce the incidence of skin irritation. Frequen
use of alcohol-based hand rub actually lessens the incidence of skin breakdown, as it does not
subject hands to the friction and abrasion involved in hand washing and drying hands.

If an individual develops compromised skin integrity, he/she should be referred to Occupational

Health for assessment.

Hand Hygiene Procedures

How do I use soap and water?

Good hand hygiene technique is easy to learn. Follow these five simple steps to keeping hands
clean:

Remove hand and arm jewellery and wet your hands with warm (not hot) running water.
Add soap, and then rub your hands together, making a soapy lather. Do this for at least 15
seconds, being careful not to wash the lather away. Wash the front and back of your hands, as
well as between your fingers and under your nails.
Rinse your hands well under warm running water, using a rubbing motion.
Wipe and dry hands gently with paper towel. Rubbing vigorously with paper towels can
damage the skin.
Turn off tap using paper towel so that you do not recontaminate your hands.
Hand Hygiene E-learning Tool -Infection Prevention and Control Canada and Discovery
Campus offer an online hand hygiene education module for healthcare workers and
volunteers

How do I use alcohol-based hand rubs?

Alcohol-based hand rubs should only be used if no visible dirt is present on the hands.

Remove hand and arm jewellery.

 Apply enough alcohol-based hand rub to make about the size of a quarter onto your hands,
enough when you rub your hands together to cover all areas of your hands, including under
your nails (1-2 pumps).
Use a rubbing motion to evenly distribute the alcohol-based hand rub over all surfaces of the
hands, particularly between fingers, fingertips, back of hands and base of thumbs.
Rub hands until your hands feel dry (minimum 15-30 seconds).

What are some mistakes I should avoid regarding hand hygiene?

DON'T leave hand jewellery on when performing hand hygiene. Jewellery is very hard to clean
and hides bacteria and viruses from the mechanical action of the washing/rubbing.
DON'T use artificial nails, nail enhancements or long (>3-4mm) nails, as they trap bacteria and
are difficult to keep clean.
DON'T wear chipped nail polish, as bacteria may become trapped along the edges
DON'T use a single damp cloth to wash a group of patient's/resident's/children's hands.
DON'T use a standing basin of water to rinse hands.
DON'T use a common hand towel.
DON'T use sponges or non-disposable cleaning cloths. Remember that germs thrive on moist
surfaces.

Standards and Guidelines

IPAC Canada Position Statement: Hand Hygiene in Health Care Settings (2017)
Best Practices for Hand Hygiene in All Health Care Settings - Ontario's Provincial Infectious
Diseases Advisory Committee (PIDAC) 2014
Hand Hygiene Practices in Healthcare Settings - Public Health Agency of Canada (PHAC)
2013
Guideline for Hand Hygiene in Health-Care Settings - Recommendations of the Healthcare
Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand
Hygiene Task Force
WHO Guidelines on Hand Hygiene in Health Care (May 2009)
STOP! Clean your hands Canada's Hand Hygiene campaign developed in conjunction with
IPAC Canada, the Canadian Council on Health Services Accreditation, the Canadian Patient
Safety Institute and the Public Health Agency of Canada:

Tools & Resources

Ideas
Communications Toolkit
Just Clean Your Hands Ontario's evidence-based hand hygiene program for hospitals and
long-term care homes:

About the Program

Hand Hygiene Training Videos and Tools for Hospitals
Hand Hygiene Training Videos and Tools for Long-term Care
4 Moments for Hand Hygiene
Resources/References

Hand Hygiene Techniques - posters and brochures that show proper hand hygiene technique
through pictures:

IPAC Canada "Do It Right" Handwashing Brochure: Side 1 (outside) Side 2 (inside)

Alberta Health Services interactive hand hygiene reviewer training modules:

Modules 1-10

PICNet's Hand Hygiene Resource Page Resources from the Provincial Infection Control
Network of British Columbia (PICNet) include:

Hand Hygiene Guidelines

Hand Hygiene Educational Resources (fact sheets, diagrams, signage, interactive tools)
BC CDC Hand Hygiene Resources

SAVE LIVES: Clean Your Hands The World Health Organization's hand hygiene program
undertaken as part of the First Patient Safety Global Challenge, Clean Care is Safer Care

Global Hand Hygiene Awareness Campaign

WHO Guidelines on Hand Hygiene in Health Care
Hand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities
Guide to implementation of the WHO Multimodal Hand Hygiene Improvement Strategy
Tools and Resources
Newsletters and Updates

Hopisafe.ch A project of Hôpitaux Universitaires de Genève, focusing on hand hygiene and

other incentives to prevent hospital-acquired infections:

Hand Hygiene Campaign

Posters
Education and Teaching Aids

Infection: Don't Pass It On Campaign A project of the U.S. Department of Veterans Affairs,
with the messages "Wash your hands" and "Cover your coughs". Many educational materials
available, including:

Hand Hygiene Posters

Hand Wash/Soap & Water Posters
Restroom Etiquette Posters
Residents & Visitors Posters
Buttons & Stickers

Germs. Wash your Hands of Them. Scotland's National Hand Hygiene Campaign has useful
information, posters and other resources available:

How to Hand Wash

When to Hand Wash
Children's Pack

Centers for Disease Control and Prevention (CDC)

Hand Hygiene Resource Web Page

Hand Hygiene Interactive Training Course
Hand Hygiene Saves Lives - patient and visitor video
Educational Slide Sets and Speaker Notes

Videos

Public Health

Hand Hygiene (Peel Public Health)

Wash Those Hands! (Lincoln-Lancaster County Health Dep't, Nebraska - posters, table
tents, activity sheets)
Scrub Club (Hand hygiene games for kids from NSF International)

You'll Like Clean Hands Introduces the character Soapy (Dr. John Embil) from the Winnipeg
Health Region.
Hand Hygiene after a Disaster (CDC) Flyers, stickers and handout cards are available for use
when handwashing facilities have been interrupted:
 WHO: Save Lives: Clean Your Hands
Just Clean Your Hands
Centers for Disease Control and Prevention

Patient Admission Video - long version

Patient Admission Video - short version

Other

New England Journal of Medicine -Hand Hygiene Video [Longtin, Sax, Allegranzi, Schneider,
Pittet - N Engl J Med 2011; 364:e24]
Proper Hand Washing, Teeth Brushing and Other Hygiene Practices
Henry the Hand
Hand Hygiene Facts You Should Know (Filters Fast)
The Scrub Club
Children's Pack
The National Health Museum Classic Collection: Handwashing
Ignaz Semmelweis and the Birth of Infection Control (QSHC online)
Handwashing in Medicine: infrequent use of an ancient practice (Int J Psychosom.)
A history of hand washing: seven hundred years at a snail's pace (Pharos Alpha Omega
Alpha Honor Med Soc.)

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