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• Hand hygiene is a fundamental part of standard precaution procedures and disease control
• It helps reduce or prevent infection and transmission of microbes among people and objects
• Surgical hand washing involves washing the fingernails, hands, and forearms with a bactericidal soap or solution for 3 to 5 minutes before a surgical procedure
• Medical hand washing is done by healthcare personnel to prevent transmission of infection and is done for 40-60 seconds
• Importance of hand hygiene:

  • Prevents the spread of germs
  • Protects the patient against harmful germs carried on hands or present on their skin
  • Protects healthcare environment from harmful germs
  • Prevents hospital-acquired infections (nosocomial infections)
• Indications for handwashing:

  • Before patient contact
  • Before an aseptic task
  • After body fluid exposure risk
  • After patient contact
  • After contact with patient surroundings
• Principles and concepts of hand hygiene:

  • Use running water in a sink that drains out instead of a basin
  • Use soap, including antibacterial soap if necessary
  • Rub hands against each other for 40-60 seconds
  • Keep fingernails short and avoid jewelry that traps germs
  • Use disposable paper towels for drying hands
  • Turn off faucet using a paper towel
  • Use soap dispensers until empty and wash before refilling
• Common types of faucet control:

  • Foot pedals
  • Knee levers
  • Hand-operated handles
  • Automatic faucet
• Proper technique is important for effective hand hygiene
• Asepsis:

  • State of being free from disease-causing contaminants
  • Types: medical asepsis and surgical asepsis
• Principles of aseptic technique:

  • Only sterile items used within sterile field
  • Sterile objects become unsterile when touched by unsterile objects
  • Sterile items below waist level are considered unsterile
  • Fluids flow in the direction of gravity
  • Prolonged exposure to airborne microorganisms can make sterile objects unsterile
  • Skin cannot be sterilized and is unsterile
  • Edges of a sterile field are unsterile
• Infection:

  • Occurs when an organism enters the body and causes disease
  • Types: localized infection and systemic infection
• Signs of localized infection:

  • Tumor (localized swelling)
  • Rubor (localized redness)
  • Dolor (pain or tenderness)
  • Calor (palpable heat)
  • Functio laesa (loss of function)
• Signs of systemic infection:

  • Fever
  • Increased pulse and respiratory rate
  • Malaise and loss of energy
  • Anorexia, nausea, vomiting
  • Enlarged and tender lymph nodes
• Anatomic and physiologic barriers defend against infection:

  • Intact skin and mucous membranes
  • Peristalsis
  • Resident flora of the large intestine
  • Tears
  • High acidity of the stomach
• Interventions to reduce the risk of infection:

  • Proper hand hygiene techniques
  • Sterile technique when warranted
  • Environmental controls
  • Identification and management of clients at risk
• Chain of infection:

  • Elements that must be present for an infection to occur
  • Includes infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host
• Breaking the chain of infection:

  • Correctly cleaning, disinfecting, or sterilizing articles
  • Educating clients and support persons on cleaning methods
  • Changing dressings and bandages when soiled
  • Proper skin and oral hygiene
  • Disposing of waste appropriately
  • Ensuring fluid containers are covered
  • Proper hand hygiene
  • Instructing hand hygiene before handling food, after eliminating, and after touching infectious material
  • Wearing gloves when handling secretions
• Hand hygiene should be performed before handling food, eating, after eliminating, and after touching infectious material
• Gloves should be worn when handling secretions and excretions
• Gowns should be worn if there is a danger of soiling clothing with body substances
• Discarded soiled materials should be placed in moisture-proof refuse bags
• Urine and feces should be disposed of in appropriate receptacles
• Aseptic precautions should be initiated and implemented for all clients
• Masks and eye protection should be worn when in close contact with clients who have infections transmitted by droplets from the respiratory tract
• Masks and eye protection should be worn when sprays of body fluid are possible
• Sterile technique should be used for invasive procedures and when exposing open wounds on handling dressings
• Used disposable needles and syringes should be placed in puncture-resistant containers for disposal
• All clients should be provided with their own personal care items
• The integrity of the client's skin and mucous membranes should be maintained
• Clients should receive a balanced diet
• The public should be educated about the importance of immunizations
• Direct contact is the transfer of microorganisms from person to person; transmission by droplet can occur when a person coughs, sneezes, spits, or talks within 3 feet from another
• Indirect contact can occur through inanimate objects or through animals or insects, flying or crawling
• Airborne transmission involves droplets or dust; droplet nuclei can remain in the air for long periods and dust particles containing infectious agents can become airborne infecting a susceptible host generally through the respiratory tract
• Incubation is the time between initial contact with an infectious agent until the first signs of symptoms; microorganisms are growing and multiplying during this stage
• Full stage is the manifestation of specific signs & symptoms of the infectious agent; referred to as the acute stage
• Prodromal stage is the time period from the onset of nonspecific symptoms to the appearance of specific symptoms related to the causative pathogen; during this phase, it is still possible to transmit the pathogen to another host
• Convalescence is the time period that the host takes to return to the pre-illness stage; also called the recovery period
• Safety and security refer to freedom from psychological and physical injury, a basic human need