Occurs in a patient during the process of care in a hospital or other health-care facility which was not present or incubating at the time of admission
This includes infections acquired in the health-care facility but appearing after discharge, and also occupational infections among health-care workers of the facility
Also referred to as “nosocomial” or “hospital-acquired” infection
PREVENTION OF HEALTH CARE-ASSOCIATED INFECTION
Validated and standardized prevention strategies like HAND HYGIENE have been shown to reduce 50% Health Care Associated Infection (HCAI)
What is Hand Hygiene?
It is the procedure by which hands are made clean.
This comprises the physical removal of:
Visible dirt (often the term used is “soiled-hands”)
Transient microorganisms and some of the resident hand microorganisms.
What is Hand Hygiene?
is considered a primary measure for reducing the risk of transmitting infection among patients and health care personnel
Includes the use of
Alcohol-based hand rubs (containing 60%–95% alcohol)
Hand washing with soap and water
Alcohol-based hand rub
Done when there is no water source available
is preferred unless hands are visibly soiled because it is more effective than soap at killing potentially deadly germs on hands
Additional reasons of alcohol-based hand rub
Requires less time
Is more accessible than handwashing sinks
Produces reduced bacterial counts on hands
Improves skin condition with less irritation and dryness than soap and water
Duration of alcohol-based hand rub: 20-30 seconds
Soap and water
Is done when hands are visibly dirty or visibly soiled with blood or other body fluids or after using the toilet
Is preferred if exposure to potential spore-forming pathogens is strongly suspected
Benefits of hand hygiene
Creation of a safer working environment for medical staff and the patients
Prevention of diarrhea and uncomfortable intestinal diseases
Avoidance of common eye infections
Obstruction of respiratory tract infections
Reduction of the bacteria content on your hands
Keeping your workplace free from bacteria
Who should practice hand hygiene?
Any health worker, caregiver or person involved in direct or indirect patient care needs to be concerned about hand hygiene and should be able to perform it correctly and at the right time
Where should you perform hand hygiene?
Busy health care providers need access to hand hygiene products where patient or patient environment contact is taking place
Hand hygiene is important in all work settings, including acute care, long term care facilities, community and corporate sites
Providing alcohol-based hand rub at the point of care (within arm’s reach) is an important system support to improve hand hygiene
This enables health care providers to quickly and easily fulfill the 4 moments for hand hygiene
Where should you perform hand hygiene?
Functional hand hygiene stations should also be available for all patients, family members, and visitors, and within 5 m of toilets, as well as at entrances and exits, in waiting and dining rooms, and other public areas
Why should you perform hand hygiene?
It is the most important way to prevent the spread of germs
It helps keep you healthy by reducing the number of germs on your hands and helps reduce the spread of germs to your family, friends, coworkers, patients, residents or clients
It prevents contamination of the patient’s, client’s, or resident’s environment
5 Moments for Hand Hygiene
Before touching a patient
Before clean/aseptic procedure
After body fluid exposure risk
After touching a patient
After touching patient surroundings
Moment 1: Before contact with a patient
before shaking hands
before transferring
Clean your hands when entering or before touching the patient
Moment 1: Before contact with a patient
Patient's room
Equipment
Wheelchair or stretcher
Clean your hands when entering or before touching any object or furniture in the patient’s environment.
Moment 1: Before contact with a patient
Before taking temperature, blood pressure or pulse
Before making someone comfortable in bed
This will protect the patient from harmful organisms carried on your hands
Moment 2: Before a clean/aseptic procedure
When? Clean your hands immediately before performing a clean/aseptic procedure
Why? To protect the patient against harmful germs, including the patient's own, from entering his/her body
Preparation and administration of any medications given via an invasive medical device
Administration of medications where there is direct contact with mucous membranes
Moment 2: Before a clean/aseptic procedure
Handling dressings or touching open wounds: This prevents the patient’s own organisms from entering his or her body
Performing invasive procedures: Clean your hands immediately before any aseptic or clean procedure to protect the patient against harmful organisms
Moment 3: After body fluid exposure
Contact with blood, bodily fluids, non-intact skin or mucous membranes
Removal of gloves
Contact with contaminated items
Clean your hands immediately after an exposure risk to body fluids (and after glove removal).
Moment 3: After body fluid exposure
Performing invasive procedures
Using a tissue to wipe your nose or toilet use
This can help protect yourself and the health care environment from harmful patient organisms
Moment 4: After contact with the patient
shaking hands
transferring
making someone comfortable in bed
Help protect yourself and the health care environment from harmful patient organisms.
Clean your hands when leaving the environment after touching patient.
Moment 5: After contact with the patient environment
Contact with room
Contact with equipment
Contact with wheelchair or stretcher
Clean your hands when leaving after touching any object or furniture in the patient’s environment
Moment 5: After contact with the patient environment
Contact with home environment
Contact with treatment area or clinic room
Help protect yourself and the health care environment from harmful patient organisms.
How to perform hand hygiene?
Proper technique is important when it comes to effective hand hygiene. Without proper hand hygiene technique, we can still spread many microorganisms with our hands
Handy Tips
artificial nails, gel nails or extenders are not to be worn by staff who have direct patient contact
contaminated surfaces or objects should not be touched after performing hand hygiene.
avoid touching your face, especially your eyes and nose
fingernails should be kept short - no longer than ¼” or 0.635cm long
Handy Tips
Nail polish may be worn but should be removed when chipped
Do not “top up” a partially-used hand hygiene product dispenser
if re-usable dispensers are used, they must be emptied, washed and dried prior to being refilled. Hand lotion bottles must not be re-used
Include frequently missed areas when performing hand hygiene such as thumbs, palms, web spaces, under nails and the back of fingers and hands
Handy Tips
Rub palms and back of hands with circular motion
Special attention should be provided to areas such as the knuckles and fingernails, which are known to harbor organisms
Handy Tips
Use supplied lotions that are compatible with hand hygiene products and gloves to minimize skin irritation that can occur with frequent hand hygiene
Wearing hand and wrist jewelry is not recommended
Handwashing can prevent The SPREAD of
Escherichia Coli
Shigellosis
Streptococcal Diseases
Influenza
Common cold
Handwashing procedure
assembly of equipment
remove wristwatch/accessories
assess the hands
turn the faucet on
adjust the flow of water
wet hands thoroughly with hands lower than the elbow
apply an ample amount of soap from the dispenser
Handwashing
8. rubs hands vigorously while counting from 1-5
palm to palm
right hand over left hand with fingers interlaced
left hand over right hand with fingers interlaced
palm to palm with fingers interlaced
back of the right fingers with hands clasped
back of the left fingers with hands clasped
left thumb --> right thumb
right fingertips into left palm --> left fingertips into right palm
left wrist --> right wrist
Handwashing procedure
9. Rinse hands thoroughly while maintaining hands lower than elbow
10. Dry hands thoroughly with clean towel
11. Turn off the faucet using a clean towel
12. Discard the used towel into the provided receptacle