CDC - Blogs - Safe Healthcare - First, Do No Harm

First, Do No Harm
July 8th, 2010 2:42 pm ET -


Katherine Ellingson, PhD
Kate Ellingson, Ph.D.
CDC Epidemiologist
CDC’s Division of Healthcare Quality Promotion

In patient care, the first rule is to do no harm. I believe a huge component of that concept is hand hygiene – ensuring that every patient is touched only by clean hands . Such a simple concept, yet we know that half or fewer of healthcare personnel actually clean their hands when they should. Perhaps it’s too simple, so much so that we dismiss its importance. At the Centers for Disease Control and Prevention (CDC), we get many requests to clarify those procedures and to find out why people don’t follow them.

When should healthcare personnel wash their hands? The answer is simple - before and after direct patient contact and after contact with the immediate patient environment such as bedrails. This includes before putting on and after taking off gloves. Healthcare personnel should also perform hand hygiene after contact with bodily fluids and before aseptic tasks.

What should healthcare personnel use to disinfect their hands? CDC recommends alcohol-based handrub as the primary mode of hand hygiene. However, hands should be washed with soap and water when they are visibly soiled or after healthcare personnel have been in contact with patients with diarrheal illnesses such as Norovirus or C. difficile.

While the vast majority of healthcare providers are committed to patient safety, real barriers to proper hand hygiene do exist. Inconveniently located sinks and dispensers, skin irritation that can lead to cracking of skin, and hectic schedules can make hand hygiene difficult. At CDC, we are aggressively seeking ways to overcome these barriers. We are guiding implementation of hand hygiene recommendations, improving measurement and feedback of hand hygiene adherence rates, and learning how new technologies can help motivate healthcare workers to adopt good hand hygiene practices.

What are you hearing about this subject? What do you need to practice proper hand hygiene? What can you do today to improve? How do you feel when patients ask you to wash up? Patients, how do you feel about asking?

For more information about hand hygiene, including guidelines, promotional campaigns, and measurement tools and technologies, please visit the following websites:

•The Centers for Disease Control and Prevention (CDC): Guideline for Hand Hygiene in Healthcare Settings
•World Health Organization (WHO) “Save Lives: Clean Your Hands”
•WHO: Guidelines on Hand Hygiene in Health Care
•WHO: Hand Hygiene: Why, How & When?
•Hand Hygiene Resource Center: Hand Hygiene Presentation

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CDC - Blogs - Safe Healthcare - First, Do No Harm