S.P.I.C.E the Strategy: Prevention and Elimination
Hands are the main vehicle of transmission for all of us in everyday life.
Hand hygiene is the single most important step that each one of us can take to prevent ourselves and others from germs and viruses being transmitted.
Hand hygiene includes cleaning hands with alcohol-based hand rub or soap and water in order to remove germs, also known as microorganisms [HSE_England]
Hands should be washed with soap and water for a minimum of 20 seconds. The action of the friction and the soap helps lift bacteria, viruses and dirt so they can be rinsed off your hands. If you cannot access running water and soap then hand sanitiser should be used. Hand sanitiser is to be used on your hands and forearms following the same technique as when you wash your hands and forearms with soap and water.
Hand Washing and Hand and Forearm Washing
You must always be ‘bare below the elbow’ when at work. Washing your hands and your forearm’s at key moments in the day is critical in keeping the transmission of infections within the home low.
Even if your hands look clean, they can still carry bacteria, viruses and dirt.
How to Wash Your Hands

When do you wash your hands?
On arrival to work
Before you take your face mask off
After you have taken your face mask off
When you come back to the home post break, and before you reapply your face mask
Upon leaving work after you have removed your face mask
After using the toilet, yourself
After sneezing, coughing or blowing your nose
After contact with blood or body fluid
After handling raw food like meat and vegetables
Before and after eating or handling food
When would you sanitise your hands?
If the facility of washing your hands with soap and water is not immediately available
When using the lift
Crossing between areas in the home – different zones
After opening connecting doors
Why are there times when you are required to wash your hands and your forearms?
The technique for washing your hands is the five-point technique as shown in the picture above. When washing your hands and forearms this is extended to your lower arms up to your elbow. Ensure that when you rinse the soap from your forearm you keep your hands lower than your elbows to ensure any bacteria, viruses and dirt is washed into the sink!
Bacteria and virus can easily contaminate your forearm’s when working. Think about the amount of contact your forearms have with people and equipment? This therefore means that your forearms can become a vehicle for transmission, just like your hands!
There are certain times within the care home when hand and forearm washing is therefore required.
When would your wash hands and forearms?
When you have doffed your PPE after providing personal care for a family member
When you have doffed your PPE after providing physical clinical support to a family member
When you have doffed your PPE after emptying a clinical waste bin, this includes removing it from the building as per your homes policy on removing clinical waste
When you have doffed your PPE after providing support with eating and drinking
When you have doffed your PPE after being in an isolation area
If someone coughs or spits on you
Hand washing and the Chain of Infection
How does hand washing fit into the Strategy of S.P.I.C.E?
Handwashing is a major preventative measure in breaking the chain of infection. It is also a key part of eliminating bacteria and viruses from your hands and forearms therefore preventing transmission
Chain of Infection – Breaking the Chain through Handwashing

Supporting staff understand to achieve best practice in handwashing technique. There is a requirement for Infection Control Leads, supported by the Infection Control champions to regularly assess and review the practice of the staff team.
The modelling of best practice and the continuous review of hand hygiene standards is a fundamental aspect of the strategy to implement and embed this Standard Infection Control Precaution.