We're Washing Our Hands - 02/04/13

According to a January report in the Milwaukee Journal Sentinel (2013), "Wisconsin already has more than double the number of confirmed influenza cases than all of last season, and is approaching four times the number of flu-related hospitalizations."  Although an annual vaccination is recommended by the Centers for Disease Control (2013) to first and foremost protect yourself and others from the flu, there are other everyday preventative actions to take.   

Handwashing is an effective way of preventing the spread of infection.
Bacteria and viruses, such as the flu, get on our hands through touching objects and surfaces infected.  Without proper handwashing, these germs continue to spread.  Proper handwashing is an extremely important aspect of public health.  It is important that the entire population be educated on this simple preventative action. 
 
One intervention from the Public Health Wheel that could be applied by nurses, is outreach.  Outreach locates populations of interest at risk and provides information about the nature of concern, what can be done about it and how services can be obtained" (Nies & McEwen, 2011).

In the case of hand-hygiene, a population-of-interest or population-at-risk would undoubtedly be children.  Children are notorious "germ sharers" and spreaders of illness.  In 2009, ABC News spotlighted an elementary school in Washington D.C.  The children were asked to place clear lotion on their hands which could only be seen by black light.  Despite the knowledge of how to wash their hands, at the end of the day "out of 25 students, just two had washed well" (De Nies, 2009).  Chances are, these habits are carried into adulthood and although we know "the nature of the concern" and that germs spread illness, knowing and putting it into practice are two different things.  Children, adults, and the elderly all need to be educated and reeducated. 

For the outreach to be successful, direct and indirect education must occur.  It is important to not only teach and demonstrate to individuals face-to-face the importance of hand hygiene, but also indirectly though reminders.  Many facilities hang signs demonstrating proper handwashing that encourages and reminds people.  But in our busy and hectic lives we become desensitized to all the signs and sometimes need a gentle verbal reminder. A study in the American Journal Of Infection Control increased the adherence of visitors and nonclinical staff from 10.6% to 63.7% eight months post-intervention when "an electronic motion sensor-triggered audible hand hygiene reminder was installed at hospital ward entrances" (Fakhry, 2012).  

By educating the population and implementing unique strategies, public health nurses can decrease the spread of germs between individuals and help keep everyone healthier during this influenza season and all year round.

References
  abc

Centers for disease control and prevention. (2011, July 13). Retrieved from http://www.cdc.gov/flu/
     protect/preventing.htm  

De Nies, Y.  (2009, Sep 6). Black light shows how kids spread the germs. Retrieved from 
     http://abcnews.go.com/GMA/Weekend/experiment-reveals-kids-wash-hands/story?id=8501323

Fakhry, M. , Hanna, G. , Anderson, O. , Holmes, A. , & Nathwani, D. (2012). Effectiveness of an
     audible reminder on hand hygiene adherence. American Journal of Infection Control, 40(4), 
     320-323.  

Herzog, K. (2013, January 11).  Wisconsin flu cases already double last season's count.  Retrieved
     from http://www.jsonline.com/features/health/wisconsin-flu-cases-already-double-last-seasons-
     count-6d8bnan-186577651.html

Nies, M.A. & McEwen, M. (2011). Community/public health nursing: Promotion the health of 
     populations (5^th ed.) St. Louis, MO: Saunders/Elsevier.

Interesting to think about...Think good hand hygiene!