HANDWASHING AGENTS

There are many commercial handwashing products available for use in clinics. Because of the variety, we will discuss the two main handwashing

Figure 9-4.\Contaminated disposable bag with biohazard label.

agents used in the Navy, water-based cleaning agents and waterless handwashing agents.

Water-Based Cleaning Agents

Water-based cleaning agents include chlorhexidine, iodophors, and alcohol among the active antimicrobial ingredients approved for handwashing. Products which use aqueous quaternary ammonium ^compounds, such as those containing dilute benzalkonium chloride, are not approved. Outbreaks of nosocomial infection associated with the use of aqueous quaternary ammonium compounds have been documented. Two of the most common water-based cleaning agents are iodophors and chlorhexidine gluconate.

IODOPHORS.\These are water soluble complexes of iodine with organic compounds that are effective against all gram-positive and gram-negative bacteria and viruses. Iodophors usually do not have a long-acting germicidal action and, if used frequently, may cause severe drying of the skin.

CHLORHEXIDINE GLUCONATE.\This antiseptic is usually marketed as 4 percent chlorhexidine gluconate with 4 percent isopropyl alcohol in a sudsy base. Chlorhexidine gluconate is an effective antiseptic for reducing transient and resident microbial hand flora, and has a sustained antimicrobial effect. It does not appear to affect the skin adversely. Also, it is approved as a surgical scrub.

Waterless Handwashing Agents

Waterless handwashing agents contain 70 percent isopropyl alcohol and virtually disinfect the skin in 20 seconds. They are effective against tubercle bacilli, fungi, and viruses. Unfortunately, they are volatile, flammable, evaporate quickly, and dry the skin. Alcohol-based, waterless handwashing agents may be used in areas where handwashing sinks are not readily available.

HANDWASHING EQUIPMENT AND SOAP DISPENSERS

All patient care areas should have sinks with electronic or mechanical elbow, foot, or knee action faucet control for asepsis and ease of function.

The use of no hand (no touch) actuated soap dispenser controls is preferable. Maintenance for refillable handwashing agent dispensers is to empty, disassemble, and clean them weekly. Do not use bar soaps in bathrooms or clinical and common areas.

HANDWASHING GUIDELINES

All personnel involved in patient care must wash their hands, wrists, and forearms with a disinfectant soap and water at the following times:

At the beginning of each day.

Between patients, before and after going to lunch, after taking a break, after using the bathroom, or any time they become contaminated.

Before gloving, after degloving, and before regloving.

At the end of the day.