TOPIC 1: HAND HYGIENE

• Ignaz Semmelweis:

  • 19th-century Hungarian doctor in Vienna General Hospital
  • Noticed women giving birth died from Puerperal Fever in 1846
  • Realized lack of hand hygiene after autopsies/surgeries
  • Introduced washing hands with Chlorinated Lime Solution
• Healthcare-Associated Infection (HAI):

  • Nosocomial or Hospital Infection
  • Occurs during care in a healthcare facility
  • Not present at admission
  • Includes infections acquired in the hospital but appearing after discharge
• Impact of HAI:

  • More serious illness
  • Long-term disability
  • Unnecessary deaths
  • Prolonged hospital stay
  • Financial implications on patients
  • Reputation of the hospital
• Top 10 carriers of infectious agents: Fingers
• Hand hygiene:

  • Most important means of preventing infection
  • Includes handwashing or hand rubbing
  • 5 moments for hand hygiene
  • 2 methods: Routine handwashing and hand antiseptics
• Steps for handwashing technique:

  • Stand away from the sink
  • Use soap and scrub for at least 15 seconds
  • Rinse hands from wrist to fingertips
  • Dry hands with a clean paper towel
• Personal Protective Equipment (PPE):

  • Gloves used during blood collection and specimen handling
  • Prevent contamination and reduce microorganism transmission
  • Proper glove removal technique
• Latex Allergy:

  • Irritant contact dermatitis
  • True immediate hypersensitivity
  • Handwashing after glove removal
  • Avoid powdered gloves
  • Replace latex gloves with nitrile or vinyl gloves
• Proper removal of gloves:

  • Grasp wrist part of one glove by opposite hand
  • Pull gloves inside out and drop in proper receptacle
• Laboratory Gown:

  • Protects clothing and skin from contamination
• Masks, Face Shields, and Goggles:

  • Protection against droplets
  • Face shields and goggles protect eyes, nose, and mouth from splashes
• Hazards:

  • Biohazard: harmful material to health
  • Biohazard exposure routes: airborne, ingestion, non-intact skin, percutaneous, permucosal
  • Chemical hazards
• ROUTINE HANDWASHING

  - Uses plain soap and water

  - When hands are visibly dirty

  - After known exposure to C. difficile, B. antacids, and infectious diarrhea

  - These are spores which are the most dormant form of bacteria - Before eating

  - After restroom
• HAND ANTISEPSIS

  -Anti-microbial soap or alcohol-based sanitizer

  -Apply the sanitizer on the hands, and rub hands together for about 20 seconds or until the hands feel dry
• AIRBORNE

  • Splashes and aerosols during centrifuge and aliquot
  • Observe proper handling practices
  • Wear PPE properly
  • Use safety shields and guards
• INGESTION

  • Hands are not sanitized before handling food
  • Wash hands frequently
  • Avoid hand-to-mouth activities
  • Avoid placing items in the mouth
• NON-INTACT SKIN

  • Cuts and breaks
  • Cover the skin with breaks/cuts with non-permeable bandages
• PERCUTANEOUS

  • Exposure through the skin due to injuries from needlesticks and other sharp objects
  • Use needle safety devices
  • Wear heavy-duty utility gloves when cleaning broken glass
  • Never handle broken glass with bare hands
• PERMUCOSAL

  • Infection through mucous membranes (mouth and nose and conjunctiva of the eyes)
  • Observe proper handling to avoid aerosols and splashes
  • Avoid rubbing/ touching the eyes, nose, and mouth
• DONNING OF PPE (Don - to put ON)

  1. Gown

  2. Haircap

  3. Mask

  4. Goggles

  5. Gloves
• DOFFING (Doff - to put OFF)

  1. Gloves
  2. Googles
  3. Gown
  4. Haircap
  5. Mask