Hand-washing vs. hand sanitizing

  • Published
  • By Lt. Col. Pamela Lagrange
  • 23rd Medical Group
When recently visiting the hospital with my parents, they began questioning the dispensers of hand sanitizers they saw there. As they looked to me, a registered nurse since 1984, they asked what the purpose of hand sanitizers were.

The major point of confusion was when they should wash with soap and water and when to use hand sanitizers...or should they use both?

As a health care professional, it has long been known that humans spread microbes and consequently infections with our hands. The mantra has long been, "Hand-washing is the single most effective way to prevent the spread of infection."

Proper hand-washing has been an integral part of hospital infection control programs across North America since I have been a nurse.

However, in my 24 years in the medical profession, the term has changed from "hand-washing," to "hand hygiene." The new term is more encompassing, including the use of hand sanitization products we see on the market and in healthcare settings now.

There are four components to "proper" hand-washing--soap, water, friction and time.

The first two components are self explanatory; while some may think friction and time are obvious, it's the small things that matter.

When lathering or rubbing your hands together and creating friction, pay attention to all surfaces including the backs of hands, palms, between fingers, fingernails and wrists. Also, make sure to spend enough time when washing your hands. About 10-15 seconds is appropriate, or roughly the amount of time it takes you to sing "Mary had a little amb," or "Twinkle, twinkle little star."

Hand sanitization lacks the soap and water components that hand-washing utilizes. A hand-sanitizer is an alcohol-based product. All it takes is one pump from a bottle or dispenser, and rubbing all surfaces of the hands until the product is dry.

A common misconception with hand-sanitizing is that you rub your hands a bit and then let the product evaporate. This is not the correct use.

The Centers for Disease Control and Prevention recommends hand-washing "when hands are visibly dirty, contaminated or soiled." The use of alcohol-based hand rubs is appropriate when hands are not visibly soiled and routine decontamination of the hands is the goal.

However, there is still some controversy over this and an Internet search will certainly display pros and cons to both sides of the argument.

My advice to Airmen is this; when you are near a sink, hand-wash. If you are simply on the run and wanting to kill any germs, sanitize.

Obviously, each hand hygiene measure has its place as long as it is properly done. I take care of patients who have suppressed immune systems because of the medication they receive. I stress proper hand hygiene to them all and they live normal, healthy lives. One does not need to be a germ fanatic, just diligent and consistent (and a good singer of "Mary had a little lamb.")