under the microscope
under the microscope
By Priya Dhagat , MS , MLS ( ASCP ) CM , CIC
High Fives for Hand Hygiene
Microorganisms exist everywhere – on our bodies , on the surfaces we touch , in our environment – and our hands play a major role the transmission of bloodborne , fecal , and respiratory tract pathogens . Hand hygiene is the most simple , foundational strategy to prevent the spread of microorganisms and is integral to breaking the cycle of transmission of bacteria , viruses , and fungi , whether it be in our homes or in a healthcare setting . Performing hand hygiene and at the right moments using the proper technique is a proven and steadfast method to prevent hospital acquired infections and spreading multidrug-resistant organisms .
While hand hygiene is routinely taught and monitored in healthcare settings , it can be overlooked or inappropriately performed . Promoting awareness and adherence to hand hygiene requires multimodal interventions , strategies , and campaigns to effectively engage healthcare workers and emphasize the relationship between a basic age-old technique and patient safety .
The World Health Organization has designated May 5 , 2023 as World Hand Hygiene Day , a day to “ accelerate action to prevent infections and antimicrobial resistance in healthcare and build a culture of safety and quality in which hand hygiene improvement is given high priority .”
In celebration of World Hand Hygiene Day , here are five interesting facts to promote hand hygiene :
➊ Fingernails harbor the most bacteria on the hand .
The subungual areas of the hand harbor high numbers of bacteria , most frequently coagulase-negative staphylococci and gram-negative rods . The space between the skin and nail creates a perfect environment for growth due to the physical protection of the nail and moisture within the space . Although it may be difficult to clean compared with the rest of the hand , fingernails are often missed as most attention is given to larger surface areas , like the palms . Artificial nails are increasingly reported as having the potential to transmit infections in healthcare settings and are more likely to harbor gram-negative pathogens . Numerous studies have shown an association between nails and hospital acquired infections , including an outbreak of Pseudomonas aeruginosa in a NICU and cluster of hemodialysis-related Serratia marcescens bacteremia .
➋ Twenty seconds is the recommended time to wash hands . According to a recent study , it takes about 20 seconds of vigorous movement to dislodge viruses and bacteria across all areas of the hands . Researchers used a mathematical model to simulate the movement of particles during hand washing . In the model , two rough surfaces separated by a thin film of liquid moved past each other to mimic hands scrubbing together . The model revealed that it took about 20 seconds to enable the particles to escape into the fluid , which aligns with public health recommendations . However , researchers at Michigan State University noted an average handwashing time was just 6 seconds , far below the CDC ’ s recommended duration !
Performing hand hygiene and at the right moments using the proper technique is a proven and steadfast method to prevent hospital acquired infections and spreading multidrugresistant organisms .”
➌ Soap cleans the skin by acting as a surfactant and emulsifier . One end of a soap molecule is hydrophilic and will interact with water , while the other end is lipophilic , which repels water but will interact with oils or other biological materials . When soap is lathered , it surrounds the oils and disrupts the chemical bonds that allow microorganisms to adhere to the skin , leading to the formation of micelles that trap the dislodged particles . When hands are rinsed with water , the micelles are lifted and washed away .
➍ Our hands have resident and transient skin flora . Millions of bacteria live on our hands , many good , but also some that can may cause infection . Resident skin flora naturally live on the skin and rarely cause infection in most health individuals . While these bacteria are not typically harmful , they may cause infection in immunocompromised individuals . Examples of resident skin flora include Staphylococcus epidermidis , Staphylococcus hominis , and Coryneform bacteria . Transient skin flora consists of bacteria , fungi , and viruses that temporarily live on the skin and usually come from contact with patients or contaminated surfaces . Since we touch an average of 300 surfaces every 30 minutes , exposing us to up to 840,000 microorganisms , transient bacteria are more common than we think .
➎ Bacteria and viruses can survive on hands and surfaces for extended periods of time . Staphylococcus aureus can survive on hands for over two hours and on surfaces for up to seven months . VRE can survive on hands or gloves for up to one hour and on surfaces for four months . Clostridioides difficile spores can survive for up to five months . Enveloped viruses such as influenza virus , parainfluenza virus , and cytomegalovirus may survive on the hands up to two hours . Click here to view some jarring images of bacterial growth cultured from several items such as unused gloves , doorknobs , a nurse station mouse , a mobile phone , an ultrasound machine , and a health-care workers ’ hands .
For more information and resources for World Hand Hygiene Day , click here : World Hand Hygiene Day ( who . int )
Priya Dhagat , MS , MLS ( ASCP ) CM , CIC , is an infection preventionist and the associate director of the system-wide Special Pathogens Program within the Department of Emergency Management at New York City Health + Hospitals , overseeing special pathogen preparedness and response efforts across New York City Health + Hospitals frontline healthcare facilities . Additionally , she supports and offers subject matter expertise for infection prevention topics for the National Emerging Special Pathogens Training and Education Center ( NETEC ).
8 may 2023 • www . healthcarehygienemagazine . com