A Complete Guide on When to Wash Hands in Aged Care: The 5 Moments and More

The Centers for Disease Control and Prevention (CDC) estimates that proper handwashing can significantly reduce the risk of both respiratory and gastrointestinal infections. In aged care settings, where residents are particularly vulnerable, knowing exactly when to wash hands in aged care is the single most important action for preventing the spread of germs and protecting health.

Quick Summary

This guide details the crucial times for hand hygiene in aged care, explaining the WHO's '5 Moments' for staff and providing additional daily routine guidelines for all. It covers proper techniques, the role of alcohol-based hand rub versus soap and water, and special considerations for older residents to ensure effective infection control.

Key Points

• The 5 Moments: Care staff must perform hand hygiene at the five specific moments identified by the WHO to prevent infection transmission.

• Routine Practices: Residents and staff should wash hands regularly throughout the day, especially before meals, after using the bathroom, and after touching communal surfaces.

• When to Use Soap and Water: This method is required when hands are visibly dirty, before eating, or when dealing with specific infections like C. difficile.

• When to Use ABHR: Alcohol-based hand rub (ABHR) is the preferred method for quick and effective sanitizing when hands are not visibly soiled.

• Consistent Technique: Washing hands for at least 20 seconds, scrubbing all surfaces, and drying thoroughly is essential for maximum effectiveness.

• Protecting Skin: Using mild, moisturizing soaps can prevent skin irritation and encourage better compliance with frequent handwashing.

• Shared Responsibility: Effective hand hygiene is a collective effort involving staff, residents, and visitors to protect the vulnerable aged care population.

In aged care, proactive infection control is paramount, and the foundation of this practice is diligent hand hygiene. For care staff, residents, and visitors alike, understanding the specific moments that demand hand washing can dramatically reduce the risk of spreading bacteria and viruses in shared living environments. This guide breaks down the essential protocol for hand hygiene in aged care.

The World Health Organization's 5 Moments for Hand Hygiene

Care staff in aged care facilities are guided by a structured approach known as the World Health Organization's (WHO) '5 Moments for Hand Hygiene'. Adhering to these moments helps protect residents from harmful germs that could be transferred during care activities.

• Before touching a resident: To protect the resident from germs on your hands.
• Before a clean/aseptic procedure: Prevents germs from entering a vulnerable area during tasks like wound care.
• After body fluid exposure risk: Protects you and the environment after contact with bodily fluids.
• After touching a resident: Cleans hands to protect yourself and the environment from the resident's germs.
• After touching patient surroundings: Cleans hands after contact with surfaces in the resident's area.

Key Handwashing Moments for All in Aged Care

Everyone in an aged care setting should practice hand hygiene at several key times daily.

• Before and after eating or preparing food.
• After using the toilet.
• After blowing your nose, coughing, or sneezing.
• After touching garbage or waste.
• Before and after caring for someone sick.
• After touching communal surfaces.
• Upon entering and leaving the facility.

The Correct Handwashing Technique for Maximum Effectiveness

The CDC recommends a five-step process for effective hand washing: Wet hands, lather with soap for at least 20 seconds, rinse under clean running water, and dry thoroughly. Scrubbing between fingers and under nails is important during the lathering stage. Thorough drying is crucial as moist hands spread germs more easily.

Comparison: Soap and Water vs. Alcohol-Based Hand Rub (ABHR)

Both are effective but used in different situations.

Feature	Soap and Water	Alcohol-Based Hand Rub (ABHR)
Effectiveness	Excellent for visible dirt and broad germ range.	Preferred for rapid action on non-soiled hands.		Clinical Use	Used during C. difficile outbreaks.	Standard for most non-surgical tasks.		Indications	Use when visibly soiled, after toilet, before eating.	Use before/after touching residents, before aseptic procedures, after touching surroundings.		Skin Impact	Can cause dryness.	Less irritating than frequent washing.		Accessibility	Requires sink.	Can be placed conveniently.

Special Considerations for Aged Care Residents

Older residents may face challenges like reduced mobility or cognitive impairment. Use mild, moisturizing soaps for delicate skin. Provide assistance as needed. For residents with cognitive decline, establish consistent handwashing routines with reminders.

Conclusion

Knowing when to wash hands in aged care, following the WHO's '5 Moments' and other key times, is fundamental to preventing infections. Consistent practice using correct techniques and choosing the right product (soap or ABHR) are vital for protecting the aged care community.

References

• Centers for Disease Control and Prevention (CDC). About Hand Hygiene for Patients in Healthcare Settings. https://www.cdc.gov/clean-hands/about/hand-hygiene-for-healthcare.html
• Centers for Disease Control and Prevention (CDC). Hand-Washing Best Practices for Seniors and Family Caregivers. https://www.agingcare.com/articles/hand-washing-best-practices-for-seniors-and-family-caregivers-457306.htm
• Mariposa Training. Improving hand hygiene in the long-term care environments. https://www.mariposatraining.com/blog-posts/improving-hand-hygiene-in-the-long-term-care-environments
• Peak Medical Home Care. Global Handwashing Day: Reducing Infections in Senior Care Environments. https://peakmedicalhomecare.com/2024/09/12/global-handwashing-day-reducing-infections-in-senior-care-environments/
• Discovery Village. A Senior's Guide To Practicing Effective Hand Hygiene. https://discoveryvillages.com/senior-living-blog/a-seniors-guide-to-practicing-effective-hand-hygiene/

Frequently Asked Questions

What are the 5 moments for hand hygiene in aged care?

The World Health Organization's '5 Moments' for aged care staff are: 1) before touching a resident, 2) before a clean/aseptic procedure, 3) after body fluid exposure risk, 4) after touching a resident, and 5) after touching a resident's surroundings.

When should an aged care resident wash their hands?

Residents should wash their hands at several key times, including before eating, after using the toilet, after blowing their nose, coughing, or sneezing, and after touching communal surfaces.

When should I use soap and water versus hand sanitizer?

Use soap and water when your hands are visibly soiled, after using the toilet, or before eating. Alcohol-based hand sanitizer (ABHR) is the preferred method when hands are not visibly dirty and for routine clinical care.

How long should I scrub my hands when washing them?

The Centers for Disease Control and Prevention (CDC) recommends scrubbing your hands with soap for at least 20 seconds. Humming the 'Happy Birthday' song twice is a good way to time yourself.

Why is hand hygiene so important for the elderly?

Older adults have weakened immune systems and are more susceptible to infections like pneumonia and influenza. Proper hand hygiene is a critical preventative measure that protects this vulnerable population from outbreaks.

What can help with dry skin from frequent handwashing?

Frequent handwashing can lead to dry, irritated skin, especially in the elderly. Using a mild, moisturizing soap can help prevent this and encourage consistent hand hygiene.

What if a resident has cognitive impairment and forgets to wash their hands?

Caregivers can help by building handwashing into a consistent daily routine. Regular reminders, visual cues, and offering direct assistance with the task are effective strategies to ensure proper hygiene.