Hand Washing: Modern Fundamental Rule

Diseases related to medical services are the main obstacle to quality medical services. According to data, 37,000 people in the European Union spread 4,544,100 diseases each year, while in the United States, about 2,000,000 people are affected, and 100,000 people die each year (European Centre for Disease Prevention and Control, 2020; Centers for Disease Control and Prevention, 2020). This pollution is a real danger for many people. In general, the basic strategy to counteract the spread of hospital infections is in our own hands. Hand hygiene is a simple and practical technique that plays a vital role in controlling pollution incidents. Lack of adequate hand cleansing tests is a source of transmission of contamination associated with normal medical services, and these contaminations may affect the urinary, respiratory, and gastrointestinal networks, as well as in places of caution.

Hand Hygiene: A Key Principle of Today

In 2002, the United States Centers for Disease Control and Prevention (CDC) issued a revised rule that once again revealed the importance of hand cleaning. The rule recommended the use of alcohol-based solutions for hand disinfection, which are not easy to detect, and the use of detergents and water for visible contamination (CDC, 2002). In a study by Girou et al. (2002), it was found that alcohol-based hand sanitizer was more successful in reducing bacterial contamination than washing hands with detergent. Unfortunately, the hand hygiene compliance of medical staff is very poor. According to the American Association of Healthcare Epidemiology, only 31% of healthcare providers understand correct hand hygiene practices (Boyce & Pittet, 2002). In addition to medical staff, medical students are also heavily involved in patient care. It can be assumed that medical students understand and follow these hygiene habits, but a study conducted during the Structural Observational Clinical Examination (OSCE) in Saudi Arabia found that only 17% of medical students adhere to hand hygiene (Alotaibi et al., 2016). Factors leading to these inadequate results include lack of awareness and knowledge, misunderstandings of workplace practices, and the influence of peers.

Case Study: Pakistan

Pakistan is one of the countries that lists infectious diseases as a major risk and the main source of patient morbidity and mortality. A survey of doctors, nurses, and medical students from Rawalpindi Medical University Hospital showed that although medical students received a lot of education on hand hygiene, only 37% of healthcare professionals conducted hand washing trials (Khan et al., 2017). WHO's strategic handwashing share is only 19% behind this 37% (World Health Organization, 2009). Despite the high infection rate in Pakistan, information on hand hygiene for medical personnel is limited and often out of date. Therefore, we are trying to re-investigate the use of alcohol-based disinfectant by the emergency room staff of a tertiary medical clinic in Karachi, Pakistan. The optional point of this survey is to evaluate the information from different parts of the hand cleaning of the medical clinic staff.

COVID-19 and Hand Hygiene

COVID-19, which started in Wuhan, China, in December 2019, has now spread to 113 countries and regions outside of China (World Health Organization, 2020). SARS-CoV-2 is a coronavirus that can infect humans. The disease usually manifests as fever, dry cough, and shortness of breath. In a medical service setting, this requires observing respiratory tract cleanliness and hand hygiene and utilizing appropriate personal healthcare services. The World Health Organization (WHO) has clearly stipulated that medical personnel should require patients to cover their nose and mouth with handkerchiefs or elbows, to cover their mouth and nose with handkerchiefs or elbows, and to wear masks for COVID-19-related patients, and that they provide proper care and hand hygiene (World Health Organization, 2020). Alcohol-based hand sanitizer (ABHR) is widely used around the world because it may be the best, simple, and low-cost way to combat the cross-spread of COVID-19. By denaturing proteins, alcohol inactivates enveloped viruses (including coronaviruses), so the ABHR formula basically contains 60% ethanol, which has been proven effective in cleaning hands (Kampf, 2020). Medical staff must comply with the WHO's Moments for My Hand Hygiene: before touching the patient, before cleaning or aseptic operations, after touching bodily fluids or risks, after touching the patient, and after touching the patient's surroundings.

Conclusion

In conclusion, hand hygiene is the main and first-step protection. Due to the current situation with COVID-19, it is important to use alcohol-based hand sanitizer (ABHR) both for medical workers and ordinary people. Moreover, WHO has created a six-step strategy, which is to apply a palm full of ABHR to cover all surfaces of the hand, and then rub it until the hand is visibly clean. This six-step strategy can be found on the official WHO's website. Emphasizing hand hygiene as a fundamental rule could significantly reduce the spread of infections and improve overall public health.

References:

Alotaibi, F., Yezli, S., Bin Saeed, A. A., Turkestani, A., & Alsaedi, A. (2016). Hand hygiene knowledge and practices among healthcare workers in Saudi hospitals: A cross-sectional study. Journal of Infection and Public Health, 9(5), 554-561.

Boyce, J. M., & Pittet, D. (2002). 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. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 51(RR-16), 1-45.

Centers for Disease Control and Prevention. (2020). Healthcare-associated infections. Retrieved from https://www.cdc.gov/hai/

European Centre for Disease Prevention and Control. (2020). Healthcare-associated infections. Retrieved from https://www.ecdc.europa.eu/en/healthcare-associated-infections

Kampf, G. (2020). Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. Infection Prevention in Practice, 2(2), 100044.

Khan, H. A., Baig, F. K., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482.

World Health Organization. (2009). WHO guidelines on hand hygiene in health care. Retrieved from https://www.who.int/gpsc/5may/tools/who_guidelines-handhygiene_summary.pdf

World Health Organization. (2020). Coronavirus disease (COVID-19) pandemic. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019