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It's a dirty world: proper hand washing techniques can halt the spread of infections.

Consider what you casually touch during the day. Every day without thinking, we touch potentially thousands of objects. You grab your shoes, the toilet handle and your car door in the morning on your way to work. There's the escalator banister, subway handle or that grubby ten dollar bill you use to pay for breakfast. These things are potentially dangerous because we touch them intuitively.

It stands to reason that the more you touch, the more germs can accumulate on your hands and the more potentially infectious they can be. We live in an era where drug resistant superbugs once thought to exclusively infect their hosts in hospitals have now moved into the community. This new crop of superbugs, known as gram negative bacteria, are said to rival even the insidious MRSA. (1)

There is more--infections that are commonly spread through hand-to-hand contact include the cold and the common flu virus and infectious diarrhea. (2) However, this winter season seems especially primed to offer an unhealthy dose of H1N1 flu (i.e., "Swine Flu"). At particular risk are those who are pregnant or have young children. Childcare providers and people with chronic medical conditions are also deemed highly susceptible. (3)

As healthcare professionals, our aseptic techniques and adherence to infection control standards are just what the doctor ordered to help stem the spread of this virus. Although we've known the benefits of hand washing for years, many people don't even wash them after using the toilet. Several studies indicate that healthcare providers don't always wash hands between patient visits. (4)

You can reverse these trends by simply washing your hands with soap and water or using an alcohol-based hand rub. In general, regular soap is fine. The combination of scrubbing your hands with soap--antibacterial or not--and rinsing them with water loosens and removes bacteria from your hands.

Here are some quick and easy techniques to help protect you, your patients and your family's health:

1. Turn water on and wet your hands and wrists.

2. Work soap into a lather.

3. Vigorously rub together all surfaces of the lathered hands for at least 15 seconds. Friction helps remove dirt and microorganisms. Wash around and under rings, around cuticles, and under fingernails.

4. Rinseyour hands thoroughlyunder a stream of water. Running water carries away dirt and debris. Point fingers down so water and contamination won't drip toward elbows.

5. Dry your hands completely with a dean dry paper towel.

6. Use a dry paper towel to turn off faucet.

When hand washing facilities are not available at a remote work site, use appropriate antiseptic hand cleaner. Use the following techniques when using alcohol-based hand rubs:

1. Apply the product to the palm of one hand. (Note: Do not use if hands are visibly contaminated.)

2. Rub hands together, covering all surfaces of hands and fingers, until hands are dry.

3. Follow manufacturer's recommendations regarding volume of product used.

Another helpful way to prevent the spread of infections is to practice measures to contain respiratory secretions. These are recommended for individuals with signs and symptoms of a respiratory infection. Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by coughing or sneezing and undean hands.

To help stop the spread of germs: (5)

1. Cover your mouth and nose with a tissue when you cough or sneeze.

2. If you don't have a tissue, cough or sneeze into your upper sleeve, not your hands.

3. Put your used tissue in the wastebasket.

WASH your hands!

Educating our hospitals, schools and communities about the importance of hand washing is simply not enough. We must successfully educate others about the spread of infectious diseases and how this often overlooked first step is crucial to winning the fight. Sure, we will continue to get up every day and touch many things that in the end could potentially harm us, but with a bit of soap and water we can stay a step ahead of that grubby ten dollar bill.


(1.) Methicillin-Resistant Staphylococcus aureus. Smith, Stephanie. "Gram-negative bacteria are drug-resistant superbugs to watch for" CNN Medical Unit: Daily Dose. 20 February 2009. index.html.

(2.) Mayo Clinic Staff, "Hand washing: an easy way to prevent infection" Mayo Foundation for Medical Education and Research (MFMER). 19 Mar. 2009.

(3.) "Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season" Centers for Disease Control and prevention. CDC.Gov. 22 Sept. 2009.

(4.) Torrey, Trisha. "Taking Infections Seriously in Scotland: Wash Your Hands or Lose Your Job." 07 Jan 2009. /2009/01/07/taking-infections-seriously -in-scotland-washyour-hands-or-lose-your-joh.htm.

(5.) Respiratory Hygiene/Cough Etiquette, "Respiratory Hygiene/Cough Etiquette in Healthcare Settings." 1 Aug. 2009.

TSgt Patricia M. Wheatley is a native of North Collins, N.Y She started her Air Force career in April of 1998. Her duty stations include Peterson AFB, Colo., Ramstein AB ,Germany, and her current station at Boiling AFB, D.C., where she assumed the position of NCOIC of Infection Control and the Dental Instrument Processing Center.

MSgt Timothy S. Phillips is from Pottstown, Pa., and entered the Air Force in 1985. He was stationed at Sheppard AFB, Texas, and later became a Training Instructor for the AF's dental assisting course. He's worked at Beale AFB, Calif., Lackland AFB, Texas, where he served as a Military Training Instructor, and at Vance AFB, Okla. He also did a tour of duty at Osan AB, Korea, where he worked in the clinic, and a year with the Inspector General. He is currently stationed at Bolling AFB, D.C.
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Title Annotation:U.S. Air Force
Author:Wheatley, Patricia M.; Phillips, Rimothy S.
Publication:The Dental Assistant
Geographic Code:1USA
Date:Nov 1, 2009
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