Are Our Hands Still Clean?

Sir

In the times of COVID-19 crisis, the value of hand hygiene among healthcare workers is not merely a personal issue.¹ According to United States Centers for Disease Control and Prevention (CDC), each year two million Americans acquire an infection while they are in the hospital. The hardest part of the infection control team in those hospitals is not coping with the variety of contagions they encounter or the panic that sometimes occurs among patients and staff.² Instead, their greatest difficulty is getting clinicians to do one simple thing that consistently halts the spread of infection: washing their hands.³ There is not much, which has not been tried earlier.

“Clean Hands Save Lives,” we have heard it numerous times. But are our hands really clean? Is WHO 7 Steps procedure adequate for cleanliness of our hands?⁴,⁵ We have noticed that WHO protocol covers maximum areas of the palms except for the most medial part of the little finger and palm and the most lateral part of the index finger and palm in the anatomical position. These areas are left neglected from scrubbing during the routine steps of surgical scrub and maybe a potential site of germ habitation. Putting an emphasis on it, we put forward two additional steps in the routine handwashing technique increasing to 9 steps instead of previous 7 (Fig. 1). These additional steps should cover the neglected part of our hand making it “Clean Hands.” These steps add 15 seconds more to the routine WHO protocol. Just additional 15 seconds make your hands safer in terms of transmitting infection. At present, our observation is a proof of concept which needs further validation with microbiological assessment in observational comparison with standard WHO protocol.