Notes from the field: The sound of no hands washing

By: July 14th, 2009 Email This Post Print This Post

Last week as I was doing a mock OSHA inspection I saw several employees standing by the restroom door listening to the activities going on in the restroom.

As I tried to control my response to this comical picture, I whispered the question “why are you standing outside this door?”

The response: they were listening to see if this very prominent physician washed his hands before coming out of the restroom.

I motioned them to follow me to the break room and tell me what was going on. They didn’t think this physician washed his hands at all, during the day. They never heard the water running in the restroom or exam rooms.

That led to a discussion on the OSHA requirement to wash hands after using the restroom, before/after each patient encounter, and when removing gloves. The staff was very concerned about the issue.

I felt inclined to speak to this physician, and once I did, the mystery was solved. The soap in the restroom and exam rooms was “regular” soap not antibacterial. The physician felt he should be using antibacterial soap, therefore he carried a small bottle of antibacterial gel in his pocket. What a relief!

Many of us scrub with antibacterial soaps assuming they are better at killing our microbial enemies, but those antibacterial soaps are no better than regular soap at killing germs. The gels are approved for use when regular soap and water are not available. I explained to him that the latest FDA studies have shown there is really no advantage to antibacterial soap.

“Popular antibacterial soaps and washes are no more effective at preventing illness than plain (and less expensive) soap and water,” an FDA advisory panel warned.

I assured the physician the regular soap and water was fine for the purpose of hand hygiene and controlling the spread of germs.

Regardless of the type of soap that you use, scrub for at least 15 seconds.

Editor’s note: Download a free pictorial guide to hand hygiene technique with alcohol-based formulation from the OSHA Healthcare Advisor Tools page.


By Barbara Piskor on July 18th, 2009 at 2:34 pm

Is there a reason the pictorial for alcohol-based hand gel has a 20-30 second time versus the 15 sec hand hygiene rule? It might be required contact time but am seeking clarification since I had not seen CDC guidance related to contact time. Is amount of gel significant? Thank you.

By Kathy Rooker on July 20th, 2009 at 9:16 am

The 20-30 second time frame, is the time required to “air-dry” your hands after using the alcohol based hand gel. A recent article on the CDC web site, recommended using a teaspoon of hand gel when cleaning your hands.

By joan billows on September 10th, 2009 at 7:08 am

What percetage of alcohol is required in a hand gel to kill germs most common in school children?

By David LaHoda on September 10th, 2009 at 4:21 pm

I don’t know of any CDC guidance qualifying the percentage of alcohol-based hand sanitizers specific to school settings. The CDC Guideline for Hand Hygiene in Health-Care Settings says sanitizers with 60%-90% alcohol are effective.

There have been some concerns about the alcohol content of hand sanitizers and either accidental for intentional ingestion. See the post, “Hand sanitizer happy hour.”

In fact some school districts have moved to alcohol-free sanitizers according to the article “Teachers keep an eye on the hand cleansers.” But the article quoted the CDC saying: “”Scientific evidence is not as extensive’ on alcohol-free products.”


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