Hand Hygiene for Caregivers and Home Health Aides

Why your hands matter most

If you care for someone at home or work as a home health aide, your hands touch more than anything else in the day: skin, bandages, bedding, pill bottles, doorknobs. In healthcare, MRSA usually spreads through direct contact with an infected wound or on contaminated hands.⁴

The good news is that hand hygiene is simple and it works. The CDC notes that some healthcare providers clean their hands as often as 100 times in a shift.¹ You may not need that many, but the same moments apply at home. Home care has its own challenges, too: often no sink near the bed, a shared bathroom, and many different surfaces in a single visit. A plan for when and where you clean your hands makes it easier.

The moments that count

Clean your hands:

• Right before you touch the person you care for¹
• Before a clean task, such as changing a dressing or handling a catheter¹
• When you move from a soiled area of the body to a clean one¹
• After touching the person or the things around them, like bed rails and remotes¹
• After contact with blood, body fluids or dirty surfaces¹
• Right after you take off gloves¹
• Before preparing food, after using the toilet or helping someone else use it, and after touching garbage²

Sanitizer or soap?

For most moments, alcohol-based hand sanitizer is the better choice. Unless hands are visibly soiled, the CDC prefers it in clinical care because it kills germs on hands more effectively than soap.¹ Choose one with at least 60% alcohol. Cover all surfaces of your hands and rub until they are dry, which takes about 20 seconds.³

Use soap and water when your hands are visibly dirty, before eating, and after using the restroom.¹ Sanitizer may not work as well on dirty or greasy hands, and it doesn’t remove some germs, such as norovirus.³

When you do wash, do it well:

• Wet your hands with clean running water, warm or cold, and apply soap.²
• Lather the backs of your hands, between your fingers and under your nails.²
• Scrub for at least 20 seconds.²
• Rinse well, then dry with a clean towel or air dryer.²

At a client’s home, a paper towel for drying is a good idea, so you aren’t sharing a hand towel.

Gloves help, but they don’t replace clean hands

Gloves are not a substitute for hand hygiene. Clean your hands before you put gloves on, and always clean them after you take gloves off, even if the gloves looked clean.¹

If you move from a dirty task to a clean one, such as from toileting to a dressing change, take the gloves off, clean your hands and put on a fresh pair.

Care for your skin and nails

Cleaning your hands many times a day can dry them out, and cracked skin is harder to keep clean.

• Use hand lotion to prevent dryness. At work, pick one your employer approves so it won’t interfere with sanitizer.¹
• Avoid hot water, and pat your hands dry rather than rubbing.¹
• Keep natural nails no longer than your fingertip. Germs can live under artificial nails, even after cleaning.¹
• Consider leaving rings at home. Some studies found more germs on skin under rings.¹

For the other things your hands touch all day, read Phones, badges and stethoscopes.

Make it easy to do

Good habits stick when supplies are where you need them. Keep sanitizer by the bed, at the front door and in your bag. Clean your hands when you arrive at a client’s home and again before you leave.

Bring the rest of the household along, too. The person you care for should clean their hands before and after a dressing change, and visitors should clean their hands when they come in and when they leave the room.⁶ Short, friendly reminders work better than lectures.

When to see a doctor

Watch the skin of the person you care for, and your own. Call a doctor if you notice:

• A bump or wound that is red, swollen, warm, painful or draining pus⁵
• Any skin infection with a fever⁵
• A skin infection that isn’t better within 48 hours⁵
• Any sign of infection in someone who is older, has diabetes or has a weak immune system

Call 911 or get urgent care for confusion, trouble breathing, or fever with fast-spreading redness. If the person you care for has MRSA, see caring for someone with MRSA at home.