"Hand Hygiene: How Many Times a Day, According to WHO"

The World Health Organization (WHO) has long been a champion of hand hygiene, recognizing its critical role in preventing healthcare-associated infections. But how many moments of hand hygiene does the WHO recommend? Let's delve into the details, backed by the WHO's guidelines.

Understanding the Five Moments for Hand Hygiene

The WHO's "Five Moments for Hand Hygiene" is a globally recognized strategy to reduce healthcare-associated infections. It's based on the idea that hand hygiene should be performed at specific times when there's a risk of transmitting infections.

Moment 1: Before Patient Contact

Before touching a patient, healthcare workers should clean their hands to prevent transmitting germs. This is the most important moment as it helps ensure that the patient's environment remains clean and safe.

Moment 2: Before Aseptic Procedures

Before performing an aseptic procedure, such as inserting an intravenous (IV) line or performing surgery, hands should be cleaned to minimize the risk of introducing infection.

Moment 3: After Body Fluid Exposure/Risk

After exposure to a patient's blood, bodily fluids, secretions, or excretions, hands should be cleaned to remove potential pathogens. This is crucial to prevent self-contamination and the spread of infection to others.

Moment 4: After Patient Contact

After touching a patient, hands should be cleaned to remove any germs that may have been picked up. This helps prevent the spread of infection to other patients or surfaces.

Moment 5: After Contact with Patient Surroundings

After touching a patient's surroundings, such as their bed, equipment, or clothing, hands should be cleaned. This is because these surfaces can harbor pathogens and transmit infections.

Hand Hygiene Techniques: A Quick Guide

Now that we've covered the moments for hand hygiene, let's briefly discuss the techniques recommended by the WHO.

• Handwashing: Use soap and water for visibly dirty hands or when hands are obviously contaminated. The technique involves wetting hands, applying soap, lathering, rubbing hands for at least 20 seconds, rinsing, and drying.
• Alcohol-based hand rub: This is the preferred method when hands are not visibly dirty. Apply the product to the palm of one hand and rub hands together, covering all surfaces, including between fingers and around nails. Continue rubbing until hands are dry.

Hand Hygiene Products: What the WHO Recommends

The WHO recommends using alcohol-based hand rubs containing ethanol or isopropanol in the range of 60% to 85% (v/v). These are effective against a wide range of pathogens and have the added benefit of being faster and more convenient than handwashing.

Product	Recommended Concentration
Ethanol-based hand rub	60% to 85% (v/v)
Isopropanol-based hand rub	60% to 85% (v/v)

Soap and water should be used when hands are visibly dirty or contaminated with blood or bodily fluids. Plain soap is adequate, but antimicrobial soap is not recommended as it does not provide additional benefits and may contribute to antibiotic resistance.

Monitoring and Improving Hand Hygiene Compliance

To ensure that hand hygiene practices are effective, healthcare facilities should monitor compliance and provide regular training. The WHO recommends using direct observation, self-reporting, and patient reporting for monitoring. To improve compliance, facilities should provide adequate supplies, education, and reminders, and involve healthcare workers in decision-making processes.

In conclusion, the WHO recommends performing hand hygiene at five specific moments to maximize its effectiveness. By understanding these moments and adhering to the recommended techniques and products, healthcare workers can significantly reduce healthcare-associated infections and improve patient safety.