Paul Jakeway
Professional Comment

Integrating Effective Hand Hygiene Into The Everyday Running Of Your Care Home

Paul-JakewayRigorous hand hygiene is crucial to reduce the spread of germs and bacteria – and prevent infections. Paul Jakeway, Marketing Director at skin care specialist Deb, explains how care home providers can raise levels of staff compliance, and improve the skin condition of employees at the same time.

Care homes can be hotbeds for the spread of infections. To protect residents, providers need to take hand hygiene seriously. But with institutions being asked to do ever more with ever fewer resources, the integration of effective hand hygiene – in a way that doesn’t hinder the everyday running of a home – can be a challenge.

According to the Department of Health, hand hygiene should happen after each and every “episode” of caring – immediately before and after there has been direct contact with a person, as well as after any other activity that might have contaminated hands. How can care home providers make sure this is the case?

Make sure you have the right facilities

As the Department of Health stresses: accessible hand hygiene facilities are a crucial first step in any effort to increase hand hygiene compliance. If they do not exist, staff should bring this to the attention of the care home management immediately. If they do, care home providers should ask themselves: are our facilities at their most effective? Does their location make sense? How accessible are they? What stands in the way of staff using them as frequently as they should to assure maximum compliance?

Modern dispenser design allows for much more flexibility when it comes to the location of hand hygiene opportunities. Rather than to have one centrally located facility, which might require staff to walk through the building to have access, dispensers can be strategically placed throughout a care home, for instance at the exit or entry point to a resident’s room. This makes it much more likely for staff to use them regularly.

Educate and train your staff

The Department of Health, the Care Quality Commission and the WHO all agree that ongoing staff education and training are absolutely crucial. Care home staff need to know not only when or how often to wash their hands – but how. When are alcohol sanitisers appropriate, and when not? When should a soap product be used?

Alcohol sanitisers, for example, are not suitable for use on hands that are dirty, contaminated and soiled (e.g. faeces, bodily fluids) or during outbreaks of diarrhoeal illness (e.g. norovirus or Clostridium difficile). In such cases, washing hands with soap and water is necessary. The WHO says that quite often techniques are inappropriate even where compliance is high. Lack of knowledge, says the organisation, is one of the greatest barriers to better hand hygiene practices.

The guidance the WHO publishes on this is known as the ‘Five Moments for Hand Hygiene’. It is one the highest clinical standards care providers can aspire to. This approach – which was developed based on the most comprehensive evidence-based document available on hand hygiene – aims for hand hygiene to be performed at the correct moments, and at the correct location, within the flow of care delivery.

Innovative approaches might be rewarded. Easy-to-use training and educational kits are widely available these days, and they can help with demonstrations of hand washing techniques and the right use of products. E-Learning programmes are increasingly being used by hospitals, and could become popular with care home providers too.

Training should not be a one-off event, but an ongoing conversation between employers and employees. Regular refreshers and constant updates on infection prevention and control can help to achieve this aim, as can easily accessible information materials, such as leaflets or brochures. Large-scale posters have proven effective in keeping awareness at the level it needs to be.

Monitoring plays an important role too. The WHO recommends for healthcare providers to closely monitor their practices – as well as their infrastructure. Are we equipped to meet our challenges and meet our responsibilities? Are there problems in our infrastructure that stand in the way of better compliance? How could we make life easier for our staff?

Choose the right products

Choosing the right hand hygiene products is crucial. The WHO admits that this can be a very difficult task indeed. Cooperation between hand hygiene product suppliers and healthcare institutions has shown that an ongoing conversation can benefit both sides. Suppliers can provide cutting edge innovation, while healthcare providers report back what works and what does not work for them, as well as what their needs might be in the future.

Hand washing with soap is a fundamental step in hand hygiene practice. Apart from removing any visible soilings from hands, a good hand washing technique will remove high levels of bacteria and viruses also present on the skin. Perfume-free and dye-free foam hand wash have proven to be good products for this.

Hand sanitising is very useful in reducing microbial counts on visibly clean hands when access to running water is inconvenient. In care environments, alcohol is the preferred active biocide for skin sanitising without the need for rinsing. Effective hand sanitisers can kill up to 99.999% of common germs. Sanitisers can be provided through dispensers, or in personal issue packs so staff can carry around with them.

Think skin health

While hand washing and sanitising are the most important steps, there is a third element to a fully thought-through skin care programme: restore creams.

Frequent hand washing makes it necessary to regularly replenish the natural oils and secretions lost from the skin, preventing it to become sore, chapped or dry.

Restore creams have been formulated to help maintain the skin in a healthy condition by keeping it soft and supple. They provide hydration properties, enhance elasticity, and soothe the skin. Special conditioning and moisturising formulas help the skin’s own production of barrier lipids and support cell renewal.

For care home employees, maintaining good skin condition is vital to both their own long term health and the health of those in their care. That’s why restore creams should be applied at the end of the working day and at lunch breaks.


The implementation of a hand hygiene programme works best if it is done in cooperation – with care home providers, skin care suppliers, and organisations offering help and guidance all working together. If care home providers provide strategically placed, accessible facilities, offer ongoing staff education and training, and choose the right skin care products, they can integrate a hand hygiene programme into the everyday running of their institutions that assures the spread of germs and bacteria is kept to a minimum, and the skin health of their employees remains a priority.