Hand washing, also known as hand hygiene, is the act of cleaning the hands to remove dirt, grime, and microorganisms. If water and soap are not available, hands can be cleaned with ash. A tap water substitute is pouring water from a hanging jerry or pumpkin.
Medical hand hygiene refers to hygiene practices associated with medical procedures. Washing hands before giving drugs or medical care can prevent or minimize the spread of the disease. The main medical goal of hand washing is to clean the hands of pathogens (such as bacteria or viruses) and chemicals that can cause harm or disease. This is very important for people handling food or working in the medical field, but also an important practice for the general public.
Hand washing with soap consistently at critical moments during the day prevents the spread of diseases such as diarrhea and cholera transmitted through the fecal-oral route. People can be infected with respiratory diseases such as influenza or common cold, for example, if they do not wash their hands before touching their eyes, nose, or mouth.
Video Hand washing
Public health
Health benefits
Hand washing has the following health benefits:
- help minimize the spread of influenza
- prevention of diarrhea
- avoid respiratory infections
- precautions for infant mortality at birth in their home
- Better hand washing practices have been shown to lead to minor improvements in long growth in children under the age of five
In developing countries, child mortality rates associated with respiratory illness and diarrhea can be reduced by introducing simple behavioral changes, such as washing hands with soap. This simple action can reduce the death rate from this disease to almost 50 percent.
Interventions that promote hand washing can reduce the episode of diarrhea by about one-third, and this is comparable to the provision of clean water in low-income areas. In addition, 48% reduction in diarrheal episodes can be attributed to hand washing with soap.
Hand washing with soap is the most effective and inexpensive way to prevent diarrhea and acute respiratory infections (ARIs), such as automatic behaviors performed at home, schools and communities around the world. Pneumonia, the main ARI, is the number one cause of death among children under five, which takes the lives of about 1.8 million children per year. Diarrhea and pneumonia together cause nearly 3.5 million child deaths each year. According to UNICEF, changing handwashing with soap before meals and after using the toilet became a deeply ingrained habit of saving more lives than any vaccine or medical intervention, reducing deaths from nearly half of diarrhea and deaths from acute quarterly respiratory infections. Hand washing is usually integrated with other sanitation interventions as part of the water, sanitation and hygiene (WASH) program.
Hand washing also protects against impetigo transmitted by direct physical contact.
Perhaps a small detrimental effect of hand washing is that frequent hand washing can cause skin damage due to skin drying. Excessive handwashing is generally seen as a symptom of obsessive-compulsive disorder (OCD).
Five critical times throughout the day
There are five critical times during the day in which hand washing with soap is important to reduce the transmission of fecal-oral disease: after defecation, after cleansing the bottom of the child, before feeding the child, before meals and before preparing food or handling raw meat, or poultry.
Behavior change
In many countries, there is a low prevalence of hand washing with soap. A study of handwashing in 54 countries by 2015 found that on average 38.7% of households washed hands with soap. Some behavioral change methodologies now exist to improve the absorption of handwashing with soap at critical moments.
Hand washing groups for schoolchildren at set times of day are an option in developing countries to involve handwashing in children's behavior. The "Essential Health Care Program" implemented by the Ministry of Education in the Philippines is an example of a scaled-up action to promote the health and education of children. Worm twice a year, plus daily hand washing with soap, daily brushing with fluoride, is at the core of this national program. It has also been successfully implemented in Indonesia.
Other aspects
As a general rule, hand washing protects people with bad or not at all from droplet and air diseases, such as measles, chickenpox, influenza, and tuberculosis.
Maps Hand washing
Substance used
Soaps and detergents
Removal of microorganisms from the skin is enhanced by the addition of soap or detergent to water. The main actions of soaps and detergents are reducing the barriers to solutions, and increasing solubility. Water is an inefficient skin cleanser because fat and protein, which is a component of organic soil, is not readily soluble in water. Cleaning, however, is helped by a reasonable flow of water.
Solid soap
Solid soap, because of its reusable properties, can withstand bacteria obtained from prior use. A small number of studies that have seen bacterial transfer from contaminated solid soaps have concluded that the transfer is not possible because bacteria are rinsed with foam. The CDC still states "liquid soap with hands-free control for preferred expenditure".
Antibacterial soap
Antibacterial soaps have been widely promoted for health conscious people. To date, there is no evidence that the recommended use of antiseptics or disinfectants for antibiotic-resistant organisms in the wild. However, antibacterial soaps contain common antibacterial agents such as triclosan, which has a list of strains of resistant organisms. Thus, even if antibiotic resistant strains are not selected by antibacterial soaps, they may not be as effective as those marketed.
Comprehensive analysis from the University of Oregon School of Public Health shows that ordinary soap is as effective as a consumer-grade, anti-bacterial soap containing triclosan in preventing disease and removing bacteria from the hands.
Water
Comfortable hot water for hand washing is not hot enough to kill bacteria. Bacteria grow much faster at body temperature (37 C). However, warm soapy water is more effective than cold, soapy water to remove natural oils that hold soil and bacteria. Contrary to popular belief, however, scientific research has shown that using warm water has no effect on reducing the burden of microbes in the hands.
Hand Antiseptic
Hand sanitizer or hand antiseptic is a non-water based hand hygiene agent. In the late 1990s and early 21st century, alcohol rubbing non-aqueous hand hygiene agents (also known as alcohol-based alcohols, hand antiseptics, or hand sanitizers) began to gain popularity. Most are based on isopropyl or ethanol alcohols formulated in conjunction with thickening agents such as carbomers to gel, or humectants such as glycerin into liquids, or foams for ease of use and to reduce the effects of alcohol drying.
Hand sanitizers containing at least 60 to 95% alcohol are efficient germ killers. Rubbing alcohol cleansing kills bacteria, multi-drug resistant bacteria (MRSA and VRE), tuberculosis, and some viruses (including HIV, herpes, RSV, rhinovirus, vaccinia, influenza, and hepatitis) and fungi. Alcohol rub sanitizers containing 70% alcohol kills 99.97% (3.5 Log reduction, similar to 35 Decibel reduction) from bacteria in hand 30 seconds after application and 99.99% to 99.999% (4-5 log reduction) from bacteria in hand 1 minute after application.
Hand sanitizers are most effective against bacteria and less effective against some viruses. Alcohol-based hand sanitizers are almost entirely ineffective against norovirus or Norwalk virus, the most common cause of contagious gastroenteritis.
Simply hand antiseptic or rubbing alcohol should be used to completely wet or cover both hands. The front and back of both hands and between and the ends of all the fingers are rubbed for about 30 seconds until the liquid, foam or gel is dry. As well as fingertips should be washed well also rub them in both palms as an alternative.
The Centers for Disease Control and Prevention in the United States recommends washing hands over a hand sanitizer, especially when the hands look dirty. The increasing use of these agents is based on ease of use and rapid killing activity against micro-organisms; However, they should not serve as a substitute for proper hand washing unless soap and water are not available.
Frequent use of alcohol-based hand rubs may cause dry skin unless the emollient and/or skin moisturizer is added to the formula. The effects of drying alcohol can be reduced or eliminated by adding glycerine and/or other emollients to the formula. In clinical trials, alcohol-based hand sanitizers containing emollients cause much less skin irritation and dryness than antimicrobial soaps or detergents. Allergic contact dermatitis, urticarial contact syndrome or hypersensitivity to alcohols or additives present in hand rubbing are rare. The lower tendency to induce irritant contact dermatitis becomes an attraction compared to hand-washing soap and water.
Despite its effectiveness, non-aqueous agents do not clean the hands of organic matter, but only disinfect them. For this reason hand sanitizers are not as effective as soap and water to prevent the spread of many pathogens, because pathogens are still left in the hands.
The effectiveness of alcohol-free hand cleaners relies heavily on ingredients and formulations, and historically has too low alcohol and alcohol content. Recently, formulations using benzalkonium chloride have been shown to have persistent and cumulative antimicrobial activity after application, unlike alcohol, which has been shown to decrease in success after repeated use, possibly due to adverse skin adverse reactions.
Ash or mud
Many people in low-income communities can not afford soap and use ash or soil instead. Ash or soil may be more effective than water alone, but may be less effective than soap. The quality of evidence is bad. One concern is that if soil or ash contaminated with microorganisms can increase the spread of disease rather than reduce it. Like soap, ash is also a disinfectant agent (base). WHO recommends ash or sand as an alternative to soap when soap is not available.
Technique
Soap and water
One should use soap and warm water if possible, and wash all the skin and nails thoroughly. However, ash can replace soap (see substance above) and cold water can also be used.
First it should rinse the hands with warm water, keep the hands under the wrist and forearm, to prevent contaminated water from moving from hand to wrist and arm. Warm water helps open the pores, which help eliminate microorganisms, without removing skin oils. One should use five milliliters of liquid soap, to fully cover the hands, and rub wet hands, soap together, outside the running water, for at least 20 seconds. The areas most often missed are the thumb, the wrist, the area between the fingers, and under the fingernails. Fake nails and stripped nail microorganisms.
Then one must rinse thoroughly, from the wrist to the tip of the finger to ensure that the microorganism falls from the skin rather than to the skin.
People should use paper towels to turn off the water. Dry your hands and arms with a clean towel, disposable or not, and use paper towels to open the door.
Moisturizing lotions are often recommended to keep hands from drying out; Dry skin can cause skin damage which may increase the risk of transmission of infection.
Low cost option when water is scarce
Various low-cost options can be made to facilitate hand washing where tap water and/or soap is not available eg pour water from hanging jerry cans or pumpkins with appropriate holes and/or use ash if needed in developing countries (see also Substance section).
In situations where water supply is limited (such as schools or rural areas in developing countries), there are water conservation solutions, such as "tippy-tap" and other low-cost options. The tippy beats are a simple technology using a rope-ridden pitcher, and a foot-operated lever to pour a little water into a hand and a bar of soap.
Drying with a towel or hand dryer
Effective hand drying is an important part of hand hygiene, but there is some debate about the most effective form of drying in public toilets. More and more research shows that paper towels are much more hygienic than electric hand dryers found in many toilets.
In 2008, a study was conducted by the University of Westminster, London, and sponsored by the European Tissue Symposium paper towel industry, to compare the level of cleanliness offered by paper towels, warmer air hand dryers and more modern jets. hand dryer. The main findings are:
- After washing and drying the hands with warm air dryers, the number of bacteria found increased on average on the finger pads by 194% and in the palms by 254%.
- Drying with a jet-air dryer produces an average increase in the total number of bacteria on the finger pad by 42% and on the palm by 15%.
- After washing and drying the hands with paper towels, the number of bacteria is reduced on average on the finger pads up to 76% and on the palms up to 77%.
The scientists also conducted tests to determine whether there was potential for cross contamination from other toilet users and the toilet environment as a result of any type of drying method. They found that:
- The jet-air dryer, which blows air out of the unit at a claimed speed of 400 mph (640 km/h), is capable of blowing micro-organisms from the hands and units and potentially contaminating other rest rooms. user and bathroom environment up to 2 meters.
- Use of hand dryers with warm air spreads micro-organisms up to 0.25 meters from the dryer.
- Paper towels do not indicate a significant spread of micro-organisms.
In 2005, in a study conducted by TÃÆ'Ã "V Produkt und Umwelt, different hand drying methods were evaluated. The following changes in the number of bacteria after hand drying were observed:
Many different hand dryer manufacturers exist, and hand dryers have been compared against drying with paper towels.
Hand wash with tissue
Hand washing using hand sanitizing wipes is an alternative to traveling without soap and water. Alcohol-based hand sanits should contain at least 60% alcohol to be effective.
Medical use
Medical hand washing became mandatory long after Hungarian physician Ignaz Semmelweis discovered its effectiveness (in 1846) in preventing disease in the hospital setting. There are currently electronic devices in some hospitals that provide feedback to remind hospital staff to wash their hands when they forget. One study has found a decrease in the rate of infection with its use.
Method
Wash medical hands is at least 15 seconds, using soap and water or gel in large quantities to wet and rub each hand. Hands should be rubbed together with numbers that lock each other. If there is dirt under the nail, a feather brush can be used to remove it. Because germs can remain in the water in the hands, it is important to rinse well and wipe with a clean towel. Once dry, paper towels should be used to turn off the water (and open the exit door if necessary). This avoids recontinuation of the hand from the surface.
The purpose of hand washing in health settings is to eliminate pathogenic microorganisms ("germs") and avoid transmission. The New England Journal of Medicine reports that lack of hand washing remains at an unacceptable level in most medical settings, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching the patient, thus emitting microorganisms. One study showed that proper hand washing and other simple procedures could reduce the rate of catheter-related blood flow infections by 66 percent.
The World Health Organization has published a sheet showing the standard of hand washing and hand rub in the healthcare sector. Manual hand hygiene manuscripts can also be found on its website for public comment. The relevant review was conducted by Whitby et al. Commercial devices can measure and validate hand hygiene, if necessary demonstration of regulatory compliance.
The World Health Organization has "Five Moments" to wash hands:
- before patient care
- after the environment contact
- after exposure to blood/body fluids
- before the aseptic task, and
- after patient care.
The addition of antiseptic chemicals to soap ("medicine" or "antimicrobial" soap) provides the act of killing the hand-washing agent. Such a killing act may be desirable before performing surgery or in settings where antibiotic-resistant organisms are highly prevalent.
To 'rub' a person's hand for surgery, you should have a faucet that can be turned on and off without touching it by hand, some chlorhexidine or iodine leaching, sterile towel to dry hands after washing, and sterile brush for rubbing and other sterile instruments to clean in under the fingernails. All jewelry should be removed. This procedure requires washing of the hands and upper arms up to the elbow, usually 2-6 minutes. Long scrub-times (10 minutes) are not required. When rinsing, water in the forearm should be prevented from returning to the hand. After hand washing is completed, hands are dried with a sterile cloth and surgical gown is worn.
Effectiveness in health care settings
To reduce the spread of germs, it is better to wash hands or use hand antiseptics before and after caring for the sick.
To control staphylococcal infections in hospitals, it has been found that the greatest benefit of hand cleansing comes from the first 20% washing, and very little extra benefit is obtained when hand-cleansing frequency increases over 35%. Washing with ordinary soap produces more than three times the rate of bacterial infectious disease transmitted to food compared to washing with antibacterial soap.
Comparing hand-rubbing with an alcohol-based solution by washing hands with antibacterial soap for an average time of 30 seconds each shows that rubbing alcohol reduces bacterial contamination 26% more than antibacterial soaps. But soap and water are more effective than alcohol-based alcohols to reduce H1N1 influenza A virus and Clostridium difficile spores from the hands.
Developing country
In developing countries, handwashing with soap is recognized as a cost-effective tool, essential for achieving good health, and even good nutrition. However, lack of reliable water supplies, soaps or handwashing facilities in people's homes, in schools and at work makes it a challenge to achieve universal handwashing behavior. For example, in most African country handwashing faucets close to any public or private toilets are scarce, though there are cheaper options for building hand-washing places. However, low handwashing rates are more likely also the result of deep-rooted habits than by lack of soap or water.
Campaign campaign
Promotion and advocacy Handwashing with soap can influence policy decisions, raise awareness about the benefits of hand washing and lead to long-term behavioral changes of the population. For this to function effectively, monitoring and evaluation are required. One example for hand-washing promotions in schools is UNICEF's "Three Star Approach" that encourages schools to take simple and inexpensive steps to ensure that students wash their hands with soap, among other hygiene requirements. When minimum standards are reached, schools can move from one to three stars. Building a handwashing station can be part of a hand washing promotional campaign undertaken to reduce childhood illness and death.
Global Handwashing Day is another example of awareness-raising campaigns that try to achieve behavioral change.
Cost-effectiveness
Several studies have considered the overall cost-effectiveness of handwashing in developing countries in association with DALYs avoided. However, one review shows that promoting handwashing with soap is significantly more cost-effective than other water and sanitation interventions.
History
The importance of hand washing for human health - especially for people in vulnerable circumstances such as mothers who have just given birth or wounded soldiers in hospitals - was first recognized in the mid-19th century by two pioneers of hand hygiene: the Hungarian doctor Ignaz Semmelweis who working in Vienna, Austria and Florence Nightingale, England "founder of modern nursing". At that time most people still believe that the infection is caused by a foul odor called miasmas.
In the 1980s, foodborne outbreaks and health care-related infections led the US Centers for Disease Control and Prevention to be more active in promoting hand hygiene as an important means of preventing the spread of infection. The outbreak of swine flu in 2009 led to increased awareness in many countries about the importance of washing hands with soap to protect themselves from such infectious diseases. For example, posters with "correct hand washing techniques" are hung beside hand-washers in public toilets and in toilets of German office and airport buildings.
Society and culture
Moral aspect
The phrase "washing one's hands" means expressing a person's reluctance to be responsible for something or sharing involvement in it. It comes from a passage in the Bible in Matthew where Pontius Pilate washed his hands of the decision to crucify Jesus Christ, but has become a phrase with much wider usage in some British communities.
In Shakespeare's Macbeth, Lady Macbeth begins compulsively washing her hands in an attempt to clear the imagined stain, representing her guilty conscience about the crime she has committed and encouraging her husband to commit.
It has also been found that people, after recalling or contemplating unethical acts, tend to wash hands more often than others, and tend to be more appreciative of handwashing equipment. Furthermore, those allowed to wash hands after such reflection are less likely to engage in other "cleansing" compensation measures, such as volunteering.
Religion
Symbolic handwashing, using water but no soap to wash hands, is part of handwashing rituals that are featured in many religions, including Baháá'ÃÆ' Faith, Hinduism, and tevilah and netilat yadayim in Judaism. Similar to these are the practices of Lavabo in Christianity, Wudu in Islam (see also Muslim hybridism jurisprudence) and Misogi in Shint ?.
See also
References
External links
- Centers for Disease Control in hygiene hands in health care settings
- Global Public-Private Partnership for Handwashing
- Photos of cheap handwashing installations in developing countries (collected by the Sustainable Sanitation Alliance)
Source of the article : Wikipedia