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Patient information

Hand hygiene

Washing your hands is 1 of the easiest ways to protect yourself and others from illnesses such as food poisoning and flu. Washing your hands properly should take about as long as singing Happy Birthday twice (around 20 seconds). Use the following steps from the World Health Organisation while you hum:

  1. Wet your hands with water (warm or cold).
  2. Apply enough soap to cover all over your hands. You can use alcohol-based hand rub if you don’t have immediate access to soap and water.
  3. Rub hands palm to palm.
  4. Rub the back of your left hand with your right palm with interlaced fingers. Repeat with the other hand.
  5. Rub your palms together with fingers interlaced.
  6. Rub the backs of your fingers against your palms with fingers interlocked.
  7. Clasp your left thumb with your right hand and rub in rotation. Repeat with your left hand and right thumb.
  8. Rub the tips of your fingers in the other palm in a circular motion, going backwards and forwards. Repeat with the other hand.
  9. Rinse hands with water (warm or cold).
  10. Dry thoroughly, ideally with a disposable towel.
  11. Use the disposable towel to turn off the tap.

How often should we wash our hands?

We should wash our hands:

  • after using the toilet
  • after handling raw foods like chicken, meat and vegetables
  • before eating or handling ready to eat food
  • after having contact with animals, including pets

Why is it so important to wash hands properly?

Washing your hands properly removes dirt, viruses and bacteria to stop them spreading to other people and objects, which can spread illnesses such as food poisoning, flu or diarrhoea.

Washing your hands with soap and water is sufficient to remove dirt, viruses or bacteria and it can reduce the risk of diarrhoea by nearly 50%.

Who is most at risk from the effects of poor hand hygiene?

Children are particularly at risk of picking up infections and spreading them to other people. It’s especially important to make sure that hands are washed when you’re visiting someone in hospital or other healthcare setting, to help prevent the spread of infection.

Health care associated infections (HCAIs)

What is an HCAI?

This is an infection that may affect people when they are receiving healthcare. People may catch these infections in hospitals, care homes, doctors’ surgeries, health centres and even at home if they are being cared for there.

Why do some people get an HCAI when receiving healthcare?

There are lots of reasons why someone can develop an HCAI. Being ill or receiving treatment can make your natural defence system (immune system) weaker than usual. Most people won’t pick up an HCAI while they are being treated but it is impossible to completely remove all the risk during healthcare. This is because every disease, condition or procedure and sometimes medication can reduce your natural defences against infection.

What are the most common types of HCAI in hospital?

The most common types of HCAI in hospitals are urine infections, wound infections, skin infections, chest infections and sickness and diarrhoea.

What type of germs cause HCAI?

Some are caused by germs that live normally on our bodies and usually do us no harm such as Staphylococcus aureus, which many people can carry harmlessly in their nose. The most well-known are meticillin resistant staphylococcus aureus (MRSA), clostridium difficile (c-diff) and norovirus.

MRSA can cause an infection if it gets into a wound, the bloodstream, bladder or lungs.

C-diff is bacteria that some people have living naturally in their bowel. For some people unfortunately, this can develop into diarrhoea and fever and usually after certain kinds of antibiotics.

Norovirus causes sickness and diarrhoea. This may last for a couple of days and usually has no lasting effects. This virus is often reported as causing outbreaks of infection in hospitals and care homes.

What do we do to prevent HCAIs spreading?

Preventing and controlling HCAI is a national priority and all care settings are working hard to prevent the spread of infection in the NHS and care homes. This includes:

  • educating staff, patients and visitors on how to prevent and control infections, for example, washing hands regularly; getting support and advice from specialist infection control or health protection staff
  • making sure that the NHS and care homes meet government standards on HCAI
  • giving people information on how to prevent and control HCAI within all care settings and among members of the public

HCAIs are monitored and reported to Public Health England, for learning and improvement purposes.

What happens if I get an infection?

Your infection could require treatment, which probably can be given to you at home. You may be asked to stay at home for the duration of the treatment and not visit the GP surgery, they may arrange a home visit instead. If you don’t understand your condition and/or treatment please ask a member of staff.


Dehydration is a state in which our bodies do not have enough water. NHS England defines dehydration as a relative deficiency of fluid that causes adverse effects on function and clinical outcome. Dehydration can be mild, moderate or severe.

A number of poor health outcomes are associated with avoidable dehydration including some infections.

Dehydration should always be considered as a cause for any of the following:

  • dry mouth, feeling thirsty
  • headache, poor concentration, unexpected confusion, increasing agitation
  • feeling dizzy when standing up
  • lethargy, malaise, increasing sleepiness
  • noticeably drier inelastic skin
  • dark concentrated urine
  • reduced urine output


How do infections spread?

You need a germ. The germ lives in or on its host, another person, an animal or a contaminated surface, for example a door handle, worktop or equipment.

The germ is passed on by either direct or indirect contact which can be coughing, sneezing, hand contact with someone who carries the germ on their hand or by touching a contaminated surface.

If the germ then enters your system and you’re not immune to it, you can catch the infection. Generally healthy people are less likely to catch infections, as their immune system should protect them well. But if for any reason your immune system is weaker than normal, you will be more vulnerable and therefore need to protect yourself even more against any infection.

Any infection can be caught or spread were there are ill people together, this can be in a hospital, a care home a GP surgery or in a public place. The information below explains how you can help the staff to reduce infection and provide a clean and safe environment in which you receive treatment and/ or care. By following the points in this advice, you can help us to prevent vulnerable individuals picking up an infection and prevent the spread of infections. If people pick up an infection, it can cause discomfort, pain and anxiety.


Vaccines are the most effective way to prevent infection diseases. They are the most important thing that we can do to protect ourselves and our children against ill health. They prevent up to 3 million deaths worldwide every year.

Since vaccines were introduced in the UK, diseases like smallpox, polio and tetanus that used to kill or disable millions of people are either gone or very rare.

Other diseases like measures and diphtheria have been reduced by up to 99.9% since their vaccines were introduced. However, if people stop having vaccines, it’s possible for infectious diseases to quickly spread again.

Vaccine hesitancy is where people with access to vaccines delay or refuse the vaccination. The World Health Organisation (WHO) recently listed vaccine hesitancy as 1 of their top 10 biggest threats to global health.

How do vaccines work?

Vaccines teach your immune system how to create antibodies that protect you from diseases. It’s much safer for your immune system to learn this thought vaccination than by catching the diseases and treating them. Once your immune system knows how to fight a disease, it can often protect you for many years.

Are vaccines safe?

All vaccines are thoroughly tested to ensure that they won’t harm you or your child. It often takes many years for a vaccine to make it through the trials and tests it needs to pass for approval. Once a vaccine is being used in the UK it’s also monitored for any rare side effects by the Medicines and Healthcare Products Regulatory Agency (MHRA).

What’s in a vaccine?

Most people aren’t concerned about vaccine ingredients and know that they’re safe. The main ingredient of any vaccine is a small amount of bacteria, virus or toxin that’s been weakened or destroyed in a laboratory first; this means there’s no risk of healthy people catching a disease from a vaccine. It’s also why you might see vaccines being called live or killed vaccines.

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