L1: Hand Hygiene

• HCAI: HEALTH CARE–ASSOCIATED INFECTION
• HEALTH CARE–ASSOCIATED INFECTION (HCAI)

  • 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

  1. Before touching a patient
  2. Before clean/aseptic procedure
  3. After body fluid exposure risk
  4. After touching a patient
  5. 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

  1. assembly of equipment
  2. remove wristwatch/accessories
  3. assess the hands
  4. turn the faucet on
  5. adjust the flow of water
  6. wet hands thoroughly with hands lower than the elbow
  7. 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