Hand Washing Techniques

The Government of Canada has issued guidance for Canadians on proper hand washing techniques to control and prevent the spread of infectious diseases.

Hand-washing and/or using an alcohol-based hand sanitizer is effective in removing the virus from hands, which can help reduce the risk of transmission.

The guidance is based on scientific evidence and expert opinion. There is substantial evidence to support hand hygiene as a basic premise of infection prevention and control measures.

The guidance was developed to provide recommendations and direction to public health authorities, community leaders and the general public on community hand hygiene practices.  It covers a variety of situations, including when running water is available, when running water is not available, and when clean water is not available.  It also includes information on the use of alcohol-based sanitizers.

You should wash your hands:

• when they are visibly dirty;
• before preparing and immediately after handling food;
• before eating food or feeding others;
• before breastfeeding;
• after using the toilet, changing/handling diapers, or helping someone use the toilet;
• after contact with contaminated surfaces (e.g., garbage bins, cleaning cloths);
• after handling pets and domestic animals;
• after wiping or blowing nose, handling soiled tissues, or sneezing into hands;
• after contact with blood or body fluids (e.g., vomit, saliva);
• before and after dressing wounds;
• before and after giving care or visiting someone who is ill, or someone who is less able to fight off infections (e.g. diabetic, cancer patient);
• before preparing and taking medication; and
• before inserting and removing contact lenses.

When Running Water is Available

When running water is available, wash your hands with plain soap and water and dry thoroughly.  The recommended procedure for hand washing using running water is as follows:

• remove jewellery such as rings
• wet your hands up to the wrists
• apply enough soap to cover all hand surfaces
• work soap under the fingernails and around and between joints and fingers
• rinse off every trace of lather with water
• dry your hands with a clean cloth or paper towel while taking special care to dry thoroughly between the fingers
• turn off the tap/spout with a paper towel or cloth

When running water is not available

In the absence of running water, you can use two separate containers to wash your hands:  one for holding the water supply, and a second for washing your hands. The recommended procedure is:

• remove jewellery such as rings
• pour sufficient water to cover hands into the hand washing container
• wet your hands up to the wrists
• apply enough soap to cover all hand surfaces
• work soap under the fingernails and around and between joints and fingers
• remove all soap and dirt residue by moving your hands around to replicate the action of running water
• dry your hands with a clean cloth or paper towel while taking special care to dry thoroughly between the fingers
• throw out the water from the hand washing container following each individual use

When clean water is not available

When clean water is not available (e.g., during a boil water advisory or when the source or quality of the water is not known), you can:

• treat water by boiling for one minute, or
• treat water with chemicals, e.g. chlorine bleach in liquid or tablet form. (Please consult regional/provincial water decontamination guidelines before adding chlorine bleach to water, as this approach may not be effective or may be hazardous if the wrong amount of bleach is used. For example, in Ontario, it is recommended that 1.5 ounces (about 3 tablespoons) of liquid household bleach be mixed into 10 gallons (45 litres) of water. After mixing, the solution should be left to stand for at least 10 minutes prior to use (Ontario Ministry of Health and Long-Term Care, 2002),
• then follow the recommendations above for when running water is not available.

Using alcohol-based hand sanitizer

A hand sanitizer that contains at least 60%, by volume, of alcohol should be used.  The recommended procedure is:
 

• Wash your hands with soap and water (if available) to remove visible dirt such as oil, blood, body fluids, etc., and dry your hands completely after washing;
• place enough alcohol-based hand rub into the cupped palm of one hand sufficient to wet both hands completely;
• rub the liquid into the palms, backs of hands, between fingers and under nails.

See also "Hand Hygiene Recommendations for Remote and Isolated Community Settings".