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.
Add into this the amount of bacteria and dirt on even the average persons hands and you have a great route of not only blood borne viruses but also abscesses and other related infections. Washing hand protects These risks can be reduced by simple hand washing, and it only takes 30 seconds. But how well do people really wash their hands?
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.
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.
Nigel Brunsdon is the owner of Injecting Advice.com. He's been working in harm reduction since the 1990's, although he's previously a frontline needle programme worker he now spends most of his time developing online resources for drugs workers and users.