More often than not, a Vet's job turns out to be a 'dirty' job. Of course, there's more to it than just keeping the cuffs clean. Dirty hands can rapidly spread diseases between animals - and equally important, the Vet himself overruns the risk of serious illness.
Proper washing of hands is a major concern for animal owners as well. A pet can anytime give you some of its diseases that you shall receive unknowingly with your dirty hands. But, what's the need for this fuss about washing hands? Haven't we been doing it ever since we got control of our hands? Hmmm... let's see.
Did you know that October 15 is observed as 'World Hand Washing Day'?
Apart from the 'sham' hand-washing that many of us are given to, there are 3 types of hand washes; in order of increasing hygienic stringency, they are:
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| Clean Hands for a Healthy World |
- Social Handwash,
- Clinical Handwash, and
- Surgical Handwash
We'll come to these a little later. First, we shall consider some 'considerable considerations' on hand washing.
WHEN TO WASH HANDS?
Hands should be washed frequently. They should always be washed:
• At the start and finish of your shift and breaks;
• Before and after any direct animal care or contact e.g. dressings, toileting, showering;
• Between different procedures on the same animal;
• Before and after contact with invasive devices such as catheters or respiratory equipment;
• Before and after delivering an injection, fingersticks and heel-sticks;
• After contact with blood or body substances;
• After handling soiled equipment, clothing or bedding;
• After the removal of gloves;
• Before contact with any immuno-compromised animals;
• Before and after activities such as going to the toilet, eating, handling food or coughing or sneezing.
• At the start and finish of your shift and breaks;
• Before and after any direct animal care or contact e.g. dressings, toileting, showering;
• Between different procedures on the same animal;
• Before and after contact with invasive devices such as catheters or respiratory equipment;
• Before and after delivering an injection, fingersticks and heel-sticks;
• After contact with blood or body substances;
• After handling soiled equipment, clothing or bedding;
• After the removal of gloves;
• Before contact with any immuno-compromised animals;
• Before and after activities such as going to the toilet, eating, handling food or coughing or sneezing.
'CHEIROBLUTOMANIA' is the obsession for washing hands over and over again! (from cheiros = hands; ablutus = washing; mania = obsession)
WHY WASH HANDS? MAY I NOT USE HAND RUBS, HAND GELS OR HAND FOAMS?
Hand rubs, hand gels or hand foams may be used on hands that are not visibly soiled, or where hand washing facilities are not available. Hands should be washed with soap and water when visibly soiled. Intact skin is a natural defense against infection so all cuts and abrasions should be covered with a water-resistant dressing. Hands may become dry with constant hand washing, so the use of hand cream is recommended. Some hand creams may counteract the antiseptic properties in the antiseptic soaps. Also, hand creams containing oil should be avoided as they may cause latex gloves to split. Jewelry or wristwatches should be taken off as the areas beneath rings, stone settings, other jewelry and wristwatches harbor microorganisms. It is also difficult to perform a thorough hand wash whilst wearing them.
HAND WASHING TECHNIQUES
A social hand wash is a hand washing technique recommended following social-type contacts, after going to the toilet and after covering a cough or sneeze. A plain soap is often used.
- Using warm water wet your hands thoroughly including palms and back of the hands;
- Dispense soap into the palm of your hand;
- Lather the hands with soap;
- Vigorously rub your hands together cleaning palms, fingers, between fingers, the back of your hands, thumbs and wrists for at least 15 seconds;
- Thoroughly rinse off the soap;
- Turn off the taps using the elbow, foot or electronic controls. If the tap has only a normal tap handle and paper towels are available, use paper towel to turn the taps off;
- Pat dry your hands with a disposable paper towel or a clean cloth towel;
- In areas where there is a cloth roll towel, make sure you are using a clean section of the towel;
- Make sure your hands are dried well to prevent chafing;
- If using disposable paper towel, place the used paper towel in the appropriate waste bin.
"A Hand wash is one of the foremost things to promote Global Health"
- CDC, Atlanta
A clinical hand wash is used before clinical procedures, when an animal is being managed in isolation, or in outbreak situations. An anti-microbial soap, containing an antiseptic agent, is used.
- Remove rings, watches and wrist jewelry;
- Using warm water wet your hands thoroughly, including palms and backs of the hands;
- Dispense anti-microbial soap into the palm of your hand;
- Lather the hands with the soap;
- Vigorously rub your hands together cleaning palms, fingers, between fingers, the back of your hands, thumbs and wrists for at least 15 seconds;
- Rinse the soap off thoroughly;
- Keep the hands in a raised position higher than the elbows and let the excess water drip off your hands and arms;
- Turn off the taps using the elbow, foot or electronic controls. If the tap has only a normal tap handle use a paper towel to turn the taps off;
- Pat dry your hands with a disposable paper towel;
- Cloth roll towels should not be used for a clinical hand wash;
- Make sure your hands are dried well to prevent chafing;
- Place the used paper towel in the appropriate general waste bin.
A surgical hand wash is required before any invasive or surgical procedure requiring the use of sterile gloves. An antimicrobial skin cleanser, usually containing chlorhexidine or detergent-based povidone-iodine, is used. Initially, one may need to be trained and assessed in surgical hand washing technique.·
- Remove rings, watches and wrist jewelry;
- Using warm water, wet your hands thoroughly including palms, backs of the hands and forearms up to the elbow;
- Remove debris from under fingernails using a nail cleaner under running water;
- Dispense the recommended amount of antimicrobial cleanser into the palm of your hand;
- Lather the hands and forearms with the cleanser for the length of time recommended by the manufacturer, usually 2-6 minutes and covering all surfaces;
- Vigorously rub your hands together cleaning palms, between fingers, the backs of your hands, thumbs and wrists;
- Scrub each wrist area;
- Scrub the forearm areas one at a time in a wrist-to-elbow direction;
- Rinse the soap off keeping the hands higher than the elbows;
- Allow excess water to drip off at the elbows;
- Turn off the taps using the elbow, foot or electronic controls;
- Pat dry your hands with a sterile absorbent towel.
(Adapted from CDC and NSW Infection Control Center)
