Caring for hands that heal

Hargett became infected with a MRSA [methicillin-resistant Staphylocuccus aureus] while being treated for cancer. She discovered first-hand — as a health care leader and as a patient — the critical importance for vigilant hand hygiene in hospitals. As a nurse, she also sees the difficulty in being 100 percent compliant. There are emergencies, and sometimes people cut corners.

“Hand hygiene is extremely demanding for health care workers,” Hargett said. “Expecting them to wash prior to and after every contact isn’t always realistic when you think about the footpath a nurse follows during a normal shift, and that she must wash her hands twice at every stopping point. I knew we had to make compliance easier.

“Now that we have appropriate alcohol-disinfectant containers in the hallways and have gotten hard-nosed about nails, our compliance and our safety profile are much better. Fastidious hand hygiene is an essential part of keeping people healthy.”

Although she doesn’t work at the bedside, Hargett eschews artificial nails and polish and expects her nurses to do the same. She keeps her nails short, buffed and well-manicured.

“When my hands get very dry, the cuticles get tough and irritated. A manicurist will trim off dead skin around the cuticles and help keep my hands in good condition. Instead of polish — which flakes or chips, creating small reservoirs for bacteria — try buffing, which has the same visual effect as clear polish. You can buy a nail-buffing kit at the drug store.”

Rachel Hough, RN, BSN, MPH, infection prevention nurse, Northside Hospital in Atlanta

“You have to take good care of your hands. When you figure that a nurse has to wash her hands before and after patient contact — after eating, drinking, using the restroom or even touching her face — that could be 60 to 75 times a day. On the floor, we provide some really good lotion that goes well with the soap we use.

“You want to keep your hands in as good shape as possible. The hospital has dry air, so anything that will add moisture to your skin is a good thing. Use good lotion at home — I like Vaseline Clinical Therapy — and wear gloves outside to keep your hands from getting chapped by the wind and cold. Hand massages will increase circulation, and they just feel good.”

Lisa Novak-Dudek, RN, BSN, nurse manager, cardiovascular medicine, WellStar Health System

“I’ve worked a lot in ICU and CCU, which means I’d be constantly wearing plastic gloves that wouldn’t allow my skin to breathe. My hands would get pretty chapped. I use a lotion with no fragrance at home. Where there is fragrance, there is usually alcohol, and what you want is hydration.

“You should wash your hands 20 to 30 seconds before and after seeing each patient, but it doesn’t have to be with hot water, which is harder on hands. Run your hand over the top [of the other hand] and between the fingers for a more- thorough cleaning.

“If my hands are cracked or bleeding, I’ll rub Vaseline on them and wear cotton gloves at night. I use Sally Hansen cuticle oil to keep my cuticles healthy. Deep cuts can trap bacteria, so I recommend Liquid Band-Aid, which provides a water barrier and closes up the cut temporarily so that it can heal on its own.”

Janet Keen, RN, MS, CIC, director of infection prevention, Piedmont Healthcare of Atlanta

“Everyone thinks that the waterless alcohol antiseptic solutions are harsher than soap and water, but studies have shown that they are actually milder on your hands. They include emollients and other ingredients to preserve moisture in skin. We’ve also found that in the operating room, these solutions are just as effective or better [than] washing with soap and water.

“If hands are healthy, they are less likely to carry transient bacteria. We offer a special lotion to use afterward in the hospital that won’t interact with gloves. It takes a little longer, but we recommend using it.

“At home, any oil-based lotion or petroleum jelly product is good to rub on your hands. I use Aquaphor or TheraSeal Hand Protection before doing dishes or housework, because it provides a water barrier and is fragrance-free. Shea butter is very popular now, and I like it.

“Cold weather is harder on your hands. The body’s reaction to cold is to keep more blood at its core to protect vital organs, so you get less circulation in your fingers. Wear gloves when you go outside.”