BC Guidelines and Resources

Provincial Best Practices for Hand Hygiene Guidelines
Published by the BC Ministry of Health, July 2012
(The document has “Appendix 1” at the top as it was originally issued as an Appendix to a Ministry Communiqué)

Notice: The Provincial Best Practices for Hand Hygiene Guidelines are currently being updated. We will notify our community of practice and partners once the resource is revised and approved for publication.

Provincial Best Practices for Hand Hygiene Guidelines: Facilities and Infrastructure Checklist
Published by the BC Ministry of Health, November 2013
(The document has “Appendix 5” at the top as it was originally issued as an Appendix to a Ministry Communiqué)

Guidelines and Resources from Other Jurisdictions

Just Clean Your Hands (JCYH) Program, How to Protect Your Skin, and Four Moments of Hand Hygiene
Created By: Public Health Ontario
December 2023

Hand Hygiene Practices in Healthcare Settings
Created By: Public Health Agency of Canada (PHAC)
March 2012

Hand Hygiene Guidelines
Created By: World Health Organization (WHO)
January 2009

There is increasing awareness of the importance of hand hygiene (HH), not only to protect patients but to protect the health of healthcare workers (HCW). In response to an Office of the Auditor General review on hand hygiene programs in healthcare, the Provincial Hand Hygiene Working Group (PHHWG) was formed with the support of the Ministry of Health Services and the BC Health Operations Council.

The Working Group

The PHHWG is composed of representatives from each of the health authorities, the Ministry of Health, and the Provincial Infection Control Network of BC (PICNet).

Aim

The group has been tasked with developing a mandatory province-wide hand hygiene program for the health authorities and assisting in its implementation for the individual health authorities. Download the two-page backgrounder.

Hand Cleaning Compliance (Auditing) Reports

Click here for more information

Hand hygiene refers to removing or killing microorganisms on the hands and is one of the most effective measures to prevent the spread of infections. There are serious health implications and financial costs associated with healthcare associated infections (HAIs), which makes hand hygiene a priority.

Hand hygiene is the single most effective way of preventing the transmission of infections. Because microorganisms can be spread by anyone, hand hygiene is everybody’s responsibility: staff, patients, residents, visitors, and volunteers.

Either alcohol based hand rub (ABHR, also known as hand sanitizer) or soap and warm water are accepted methods of hand hygiene:

• soap and water is preferred if you have contact with a patient who is known to have C. difficile or norovirus, or if your hands are visibly soiled
• otherwise, ABHR is as effective as soap and water – and will not dry out your skin.

Patients, volunteers, and visitors should be reminded of the importance of hand hygiene, especially before eating or preparing food, after using the toilet or other personal hygiene activities, before leaving their homes for public areas, and when returning home from public places.

Two important components of hand hygiene are glove use and hand care:

Hand care

Your hands take care of others; do you take care of your hands?

Did you know that the risk of spreading infections increases if the skin on your hands is dry and cracked? Healthy skin is your best defence against infection.

You can protect your hands with a few simple tips:		You can download this information as a poster. (PDF file, 8×5 x 11)
	Choose Alcohol Based Hand Rub (ABHR) unless otherwise instructed by Infection Prevention and Control: the ABHR used in all BC Health Authority facilities contains moisturizers, and doesn’t wash away skin oils.
	When using soap, wet hands before applying soap, and avoid extremely hot or cold water (use warm). Pat dry with paper towel instead of rubbing, and dry completely. (Rubbing rather than patting, and not drying hands completely, are two of the main causes of skin irritation.)
	Make sure hands are not wet before putting on gloves, and remove gloves as soon as the task is finished. (And don’t forget you need to clean hands again after glove use!)
	Use hand lotion if skin feels dry, and let it sink in before washing your hands again.

Take care of your hands so that they can take care of you, your loved ones, and your patients.

If you think you have dermatitis or are experiencing hand/skin irritation:

1. Notify your supervisor/manager.
2. If you believe that you have dermatitis that is either caused by or made worse by your work, visit your doctor and maintain a log of any products that may be contributing to your symptoms.
3. Report signs and symptoms to the Workplace Call Centre at 1.866.922.9464. An investigation report will be sent to your manager, who will follow up with you when conducting the investigation.
4. If you think this is related to gloves, soap, hand sanitizer or any other product used within PHSA you need to report it by completing the BC Clinical and Support Services (BCCSS) Product Concern Form with your manager (you can find this form on your health authority’s intranet).

Correct glove use: An important part of hand hygiene

When to use gloves

Gloves should be worn for:

• Direct patient care:
  • when it is anticipated that the hands will be in contact with mucous membranes, non-intact skin, or bodily fluids
  • if the patient is on contact precautions
• Transporting contaminated items (or potentially contaminated)
• Cleaning spills of blood or bodily fluids.

Hand cleaning

• The use of gloves does not replace the need for hand hygiene.
• Gloves can leak (even if it’s not visible), which means that germs can get through gloves.
• Because of this, you need to clean hands before donning gloves (so that any germs on your hand aren’t transferred through the glove to the patient) and after doffing gloves (so that germs from the patient or patient environment, that have transferred to your hands, are not further spread around)

If gloves don’t protect against all germs, why do we use them?

• Think of gloves as being like a seatbelt – they give you and your patients good protection, but not 100% protection. It makes sense to use them in situations where your hands may become grossly soiled, but you must still clean hands before and after.

Donning and Doffing

• Before donning gloves, wash your hands with soap and water or clean with sanitizer, and make sure hands are completely dry.
• Gloves should be put on immediately before the activity for which they are indicated.
• Gloves should be removed immediately and discarded after the activity for which they were used, and before exiting the environment of a patient. Wash your hands with soap and water or clean with sanitizer after removing the gloves.

More important points:

• Disposable gloves should not be washed or re-used.
• Gloves should never be re-worn between patients.
• Gloves should be changed or removed when moving from a contaminated body site to a clean body site within the same patient.
• Gloves should be changed or removed after touching a contaminated environmental surface.
• Never wear gloves outside a patient room or bedspace unless transporting contaminated items or when cleaning spills of blood or bodily fluids.
• To reduce hand irritation related to gloves, wear gloves for as short a time as possible.

Many of PICNet’s infection control resources include hand hygiene:

You can find all of PICNet’s available resources via the Resources menu.