Hand Washing

I've been doing a lot of training work lately and one of the main things I always focus on is the fact that people forget the basics. Its all well and good explaining to people the risks of endocarditis or going though something like vein structure. But at the end of the day the basic advice needs to be given, I've already spoken in a previous article about the advantages of giving swabbing advice, so today is the turn of hand washing.
In Avril Taylor's study of Injecting Drug Use in Scotland the point was raised that most of the injectors observed didn't take the opportunity to wash their hands even when they had ready access to a clean water supply. As anyone who has watched the footage from this study knows this means that there are lots of hands out there with blood on them from touching fresh injecting sites.

The NTA's campaign Harm Reduction Works has DVDs available free of charge (in England) and it includes two great short films on how to wash your hands. If you have a DVD player, computer or laptop that can be taken into your NSP I'd really recommend using this resource with injectors. These are also available on the Harm Reduction Works YouTube channel.
Homeless injectors
Of course not everyone has access to clean water, so how do you follow the advice in this film if you have to use public toilets or unclean washing facilities? One option is to wash the taps before washing your hands, but that's only useful if you have access to water.
If your NSP provides alcohol gels or hand wipes these are great for homeless and outdoor injectors, but you should still give advice to still hand wash when the opportunity is there. The main reason for this is that using alcohol gel is not a replacement for washing, they won't remove all the dirt so hands can still carry a level of risk. The other thing to bear in mind is that having wet hands or greasy food residue will also reduce the gels effectiveness.
