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Hand hygiene: the simplest and strongest protection

Most germs are passed on by hands. During neutropenia, hand hygiene by both the patient and the people around them is the foundation of infection protection.

Last updated: ~1 min read
Hands being washed with soap under running water
Figure 1.Soap and water — the strongest protection

01Short answer

When: before eating and preparing food; after the toilet, blowing your nose or coughing; after touching raw meat, soil, animals, rubbish or dirty laundry; before touching a catheter or medicines; and when you come home. How: wet your hands, apply soap and rub for at least 20 seconds, covering palms, backs, between the fingers, thumbs, under the nails and wrists; rinse and dry with a clean towel or paper towel. Without soap, use a hand rub with at least 60% alcohol and rub until dry. Visible dirt and diarrhoea call for soap and water. Keep nails short and take off rings and bracelets.

02Simple explanation

20 seconds with soap.

No soap: alcohol hand rub.

Under nails and between fingers.

Visible dirt: soap and water.

03Scientific explanation

WHO: hand hygiene is one of the most effective ways to prevent the spread of infections.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Hand rub

A product with at least 60% alcohol works against most germs.

Dry skin

Frequent washing dries skin; use a fragrance-free cream (“Dry skin: keeping moisture in”).

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
Hand rubA product with at least 60% alcohol works against most germs.
Dry skinFrequent washing dries skin; use a fragrance-free cream (“Dry skin: keeping moisture in”).
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Alcohol hand rub
An alcohol-based product for hands.
Hand hygiene
Washing or rubbing the hands clean.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • 20 seconds.
  • Hand rub.
  • Cream.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

Is hand rub better than soap?

If hands are not visibly dirty, it is just as effective.

How do I teach children?

Wash for as long as it takes to sing "Happy Birthday" twice.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Is hand rub better than soap?

  2. How do I teach children?

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  2. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  3. National Cancer Institute. Anemia and Cancer Treatment
  4. World Health Organization. World Hand Hygiene Day
  5. American Cancer Society. What a Cancer Caregiver Does
  6. Blood Cancer UK. Preventing infection
  7. Centers for Disease Control and Prevention (CDC). People at Increased Risk for Illness from Animals
  8. Centers for Disease Control and Prevention (CDC). Aspergillosis Basics
  9. Journal of Clinical Oncology (ASCO and IDSA), 2018. Antimicrobial Prophylaxis for Adult Patients With Cancer-Related Immunosuppression: ASCO and IDSA Clinical Practice Guideline Update
  10. Biology of Blood and Marrow Transplantation, 2009. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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