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Skip to 0 minutes and 8 seconds Hand hygiene is really important to prevent the spread of viruses like influenza and, indeed, other pathogens like bacteria. And hand hygiene is especially important in hospitals in order to prevent the spread of infections to patients who already might be very unwell. So today I’m joined by Martin Reynolds who is a medical student at Lancaster Medical School. And Martin is going to be demonstrating the Ayliffe technique, which is a specialist hand washing technique that’s now used in hospitals to maximise the degree of hand hygiene among people who work in hospitals and prevent transmission of infections to patients. First things first, we make sure that we’re bare below the elbows. So we’ve got our whole forearms exposed.

Skip to 0 minutes and 47 seconds And then first we just turn the tap on and make sure we get our whole hands completely wet. And a little bit on the wrists as well. Now we just need a good amount of soap, just like normally washing your hands back home. Then the important part is the technique that we use now. So do get the soap into a nice lather. Keep it going all the way through the fingers. And then we move on to going in between the webbings of the hands. So we do five like this. 1, 2, 3, 4, 5. Five on the back. 1, 2, 3, 4, 5. Five on the other side. 1, 2, 3, 4, 5.

Skip to 1 minute and 18 seconds Now we move on to the fingertips, since they are the key point of fingers as a source of bacteria. 1, 2, 3, 4, 5. Nice, digging the fingertips into the balls of your hand there. Now we move on to the thumb. The thumb is another key area, as this is another part that’s been shown to have lots of bacteria when you don’t wash your hands properly. So we put some into the palm of hand and twist it five times. Now we do the fingertips again. And we swirl them, in the centre of the palm. This is just to try and dig into the fingernails, as they can be another area that bacteria like to hide in.

Skip to 1 minute and 51 seconds So we do that on both sides. Then we move to the wrists, just gripping the wrists, twisting 1, 2, 3, 4, 5, times. The same on the other side. And now we can wash all the soap off and making sure that we keep our hands in a vertical point so that all the soap is running off the hands and down towards your forearm on both sides and then being careful not to touch anything with your now clean hands. So I’m just making sure that I get all the soap off my fingers and making sure that I don’t then turn my hands upside down and allow the water to flow in the opposite direction. I’ll just give them a shake.

Skip to 2 minutes and 25 seconds Now the important thing is to turn the taps off. But if I was to touch the taps again, I would then be recontaminating my hands, so I have to use my elbows to switch them off. And my hands are still clean at this point. And I can grab a good bit of paper towel, working slowly down my hand just to make sure that I get all the drips off, working one way, turning the towel over and working the other way to make sure they stay clean. This then can go in the bin.

Skip to 2 minutes and 49 seconds And then I can take another one, do the same with the other hand, working all the way down, making sure that I don’t touch an area that was clean with the dirty side of the paper towel. And there we go, and our hands are clean and sterile to use. That’s great. Well, thanks, Martin. I mean, that’s it being done by an expert. And now I’m going to have a go, as a non-expert, see how far I can get with this. So I hope, with some of Martin’s guidance, I’ll be able to get through the process. The first thing that you’ll notice, actually, is that I really should have taken my watch off, which I’ll do now.

Skip to 3 minutes and 21 seconds So there goes my watch. And now I have a ring on, which I really should remove as well, but it’s going to be quite difficult to get it off, so I’ll leave that on. Oh, no. I start with the water. That’s right. So start with water, don’t want it to be running too hard or else I get splashing. So that’s about the right water. I’m going to try a good dot of soap, like that. And then, I think, the first process was that there. Just to get a good lather going. Just to get a good lather going. And them I’m going to do 1, 2, 3, 4, 5.

Skip to 3 minutes and 51 seconds Yep. And then 1, 2, 3, 4, 5. That’s right. And I’m going to do 1, 2, 3, 4, 5. My lather is pretty poor, I think, but we’ll bear with it. 1, 2, 3, 4, 5.

Skip to 4 minutes and 5 seconds That’s good. And then– what’s the next bit? We turn your hands over and grip your fingers like that and twist in and out. We grip the finger and we twist like that. And then I have my fingertip rule to do. Yep. And I’ve completely run out of lather by now, which is really very disappointing. So I’m doing that fingertip twist, like that. Just like that. And then it was the thumbs. Just grip the thumb, into your hand coming in like that, yeah. The thumb like that. And give it a good twist as well. And with a twist as well. There’s the thumb, the twist. And I can’t remember the next stage.

Skip to 4 minutes and 37 seconds The next step was at your wrists, just twist around your wrists. The wrists go like that. Obviously, you have to imagine this happening with a lot more soap. I don’t know where mine’s gone. So that’s it. Soap there like that. And I’m ready for a rinse now. Is that correct? Yes, that’s right. I’m ready for a rinse, so going in to rinse this way so that it’s rinsing from the fingertips downwards.

Skip to 5 minutes and 2 seconds So that’s my first hand done. Do I dry that before I rinse the second one? You’d rinse the second one first. Just make sure you don’t touch anything with the other hand. I’m not touching anything here. So these are rinsed, and I haven’t touched anything else. So I’m now ready for a wipe, and I can do– or I wipe downwards away from the finger– – wipe downwards away from the fingertips, yeah. I nearly did the wrong thing there so I’m wiping down away from the fingertips. So that’s that one discarded. And then I do the same with this one. I start with the fingertips, and I wipe downwards.

Skip to 5 minutes and 37 seconds So my hands would now be considered clinically clean, so that’s the Ayliffe technique. Oh, of course I have to switch the water off as well.

The Ayliffe Handwashing Technique

In the video on how influenza spreads, the importance of fomite transmission and hand hygiene was emphasised.

In this video, watch Lancaster University medical student Martin Reynolds demonstrate the Ayliffe Technique for hand-washing to clinical standard, and then watch a beginner (Derek) attempt it. Can you see any mistakes made by Derek?

If you would like to record yourself performing the Ayliffe technique and then upload a link to your video in the comments section, please do so.

The links below provide some other guides.

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This video is from the free online course:

Influenza: How the Flu Spreads and Evolves

Lancaster University