Resident – attached to deeper layers of skin, more resistant to removal
Transient – on superficial layers of skin, easier to remove with hand washing.

• It also discussed that automatic hand washers do not show any quality or frequency of hand washing increased when used.
• The main issue that is apparent is that education is required. There is a lack of scientific information to impact or improve hand hygiene. There is a failure to perform appropriate hand hygiene. This is the leading cause of assorted infection in health care settings.
• Poor adherence to recommended practices, a few major issue:
• Males and Physicians less likely to follow practices
• Sinks are inconveniently located/shortage of sinks
• Often too busy
• Wearing gloves/beliefs that with glove use no need for hand hygiene.
• Fingernail and Artificial Nails are a main area of concern. Chipped nail polish may grow and increase the number of organisms on fingernail; again no scientific proof only assumed at this point. Fingernails overall show evidence that pose an infection hazard.
• CDC Glove Policy- states gloves can reduce the transmission of infection and bacteria. However, those who wear gloves are less likely to wash or clean their hands prior to putting on gloves.
• Alcohol based hand rubs may be a better option than traditional hand washing w/ soap and water or antiseptic hand wash. The alcohol rubs require less time, act faster and are less likely to irritate hands less than traditional hand soaps.
• Recommendations are not for food processing. THE CDC guidelines are strongly recommended or suggested for implementation. There are really no clear cut guidelines and no one mandating them.