4.3 Hand Washing & Hand Hygiene

Hand Washing and Hand Hygiene

Ohio State Board Exam Alert: "Hand Washing" is its own named leaf under Infection Control in the Board's blueprint, and the practical examination scores "sanitizes hands" in the set-up task and again at the start of the basic manicure. Two separate marks hang on a skill most candidates treat as automatic.

Hand hygiene is the single most effective infection-control measure in any personal-service setting. It is also the one most often performed badly — rushed, too cool, or ended by drying on a shared towel.

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1. Why Hands Are the Primary Vehicle

Human skin carries two microbial populations:

Routine hand washing targets transient flora. That is why it works: the organisms most likely to move from one client to the next are exactly the ones mechanical washing removes.

The other reason hands matter is the technician's own skin. Repeated exposure to acetone, detergents, monomers and hot water strips the lipid barrier and produces irritant contact dermatitis — cracked, fissured skin that is both a portal of entry for pathogens and a reservoir that hand hygiene cannot fully clean.

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2. The Hand-Washing Procedure

   1. WET       warm running water (not hot - hot water strips lipids
                and increases dermatitis risk)
   2. SOAP      liquid soap from a pump dispenser
   3. LATHER    palm to palm; back of each hand; interlaced fingers;
                backs of fingers; each thumb rotationally; fingertips
                into the opposite palm; WRISTS; and UNDER THE
                FREE EDGE of your own nails with a nail brush
   4. SCRUB     a minimum of 20 SECONDS of friction
   5. RINSE     fingertips down, so water runs off the dirtiest area
   6. DRY       single-use paper towel or warm-air dryer
   7. TURN OFF  use the paper towel to close the tap and open the door

Three details separate a correct demonstration from a careless one:

• Friction, not soap chemistry, does the work. Twenty seconds of mechanical scrubbing is the active ingredient. Plain soap and antimicrobial soap perform comparably for routine salon use.
• Rinse with the fingertips pointing down. Rinsing upward carries contaminated water back over clean skin.
• The tap is contaminated. You touched it with dirty hands; close it with the used towel.

Ohio's restroom rule, OAC 4713-11-05, requires every salon restroom to be equipped with a soap dispenser, a waste container with solid sides or a liner, and a paper towel dispenser or hand-drying equipment — the physical infrastructure this procedure assumes.

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3. When to Wash

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4. Alcohol-Based Hand Rubs — Adjunct, Not Substitute

Alcohol-based hand sanitisers containing 60 % to 95 % ethanol or isopropanol rapidly reduce microbial counts on visibly clean hands and are an efficient between-step measure — for example after touching a shared polish rack mid-service.

Their limits are examinable:

• They do not remove soil. On visibly soiled hands the organic matter shields organisms and alcohol fails.
• They are ineffective against bacterial spores such as Clostridioides difficile, and less reliable against some non-enveloped viruses.
• They do not substitute for washing after glove removal or after a blood exposure.
• The Board's practical examination requires the manufacturer's original or photocopied original label on hand sanitiser, exactly as it does for disinfectants. A decanted, hand-labelled bottle fails.

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5. Nails, Jewellery and Gloves

• Keep your own nails short and well maintained. The subungual space under a long free edge is a well-documented reservoir for Gram-negative organisms and yeasts, and it is the hardest area to clean.
• Long or chipped enhancements on the technician interfere with glove fit and harbour organisms in lifted areas. Healthcare guidance is strict on this point for the same underlying reason.
• Rings and wrist jewellery trap moisture and organisms and should be removed before washing.
• Gloves are not a hand-hygiene substitute. Ohio requires non-porous, single-use gloves during blood or body-fluid clean-up (OAC 4713-15-03(D)(1)); they are single use, changed between clients, and never washed and reused. Wash after removal — hands sweat inside gloves, and micro-perforations are common.

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6. Hand Care for the Technician

Broken skin cannot be decontaminated, so protecting your barrier is infection control, not vanity.

1. Use warm, not hot water.
2. Dry completely, including between the fingers — residual moisture drives irritant dermatitis and fungal colonisation.
3. Apply a barrier or emollient cream after washing and at the end of the day.
4. Wear nitrile gloves for wet work and chemical handling; nitrile resists acetone and monomers far better than latex, and avoids latex allergy entirely.
5. Cover any break in your own skin with a waterproof dressing before working, and remember OAC 4713-15-13(B): a licensee with visible swelling, eruption, redness, bruising, rash or parasitic infestation may not practise without written permission from a physician.