Hand hygiene and handwashing: key to preventing the transfer of pathogens

One of the most common means of transmission that is found in healthcare environments is touch: directly by shaking someone's hand or indirectly by touching an object that has been previously touched by another. Consequently, hands can be populated with an enormous number of microorganisms, which can be inadvertently transferred from surface to surface or person to person.

Hands are colonised by two types of microorganisms: transient and resident. The first are found on the skin surface, can move around and are readily acquired from contact with other body sites, people and the environment. They are thus easily transferred to others. Resident microorganisms are the normal skin flora found in the deeper skin layers, hair follicles and sweat glands. They are more difficult to remove.

The World Health Organization (WHO)¹ highlights that within healthcare environments there are five key moments when the transfer of microorganisms can take place (Fig 1) and Loveday et al.² also advocate a further moment after removing personal protective equipment. Hand hygiene, which is seen as the single most important factor in reducing and preventing infection, should therefore be a key priority for every health practitioner.¹