HAND HYGIENE

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HAND HYGIENE

• PRESENTER
• CATHERINE W NGUGI

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Objectives

• Identify the single most effective way to reduce
  the spread of hospital associated infections
• List the two main methods of doing hand hygiene
• List the steps in proper hand washing
• Identify when hand hygiene should be performed
• Recognize incorrect and/ or unsafe hand hygiene
  practices
• Identify some of the challenges to hand hygiene
  compliance

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When to Perform Hand Hygiene

• Before After caring for patients
• Before After placement of an invasive device
• Before After preparing or handling food
• When in- contact with a patient or potentially
  contaminated surfaces / objects
• After touching blood or body fluids
• Before After removing gloves
• Before After toileting
• Between tasks on the same patient when hands are
  visibly soiled

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Normal microbial flora of skin

• Resident- survive multiply in the superficial
  skin layers
• Transient- recent contaminants that survive
  briefly. E.g klebsiella from patients or the
  environment

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Hand hygiene

• Least expensive
• Single most effective method to prevent the
  spread of many communicable diseases
• Includes
• Hand washing use of plain soap water to
  mechanically remove bacteria/ viruses and debris
• Hand sanitizer use of waterless hand gel to kill
  bacteria viruses on the hands

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Levels of hand washing

• Social hand washing
• Hygienic hand washing
• Surgical hand washing

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Hygienic hand washing

• Before after
• Invasive procedures
• Handling wounds, drains, catheters
• Susceptible patients

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Surgical hand washing

• Before all surgical procedures
• For 2-3 minutes including the wrists fore-arms
• Sterile disposable nailbrushes may be used to
  clean fingernails
• Sterile towels are used to dry the hands
  thoroughly

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How to wash your hands

• Turn the water on and wet hands
• Apply soap (plain or antimicrobial) and water to
  entire surface of hands
• Rub fingers back and forth, and wash around the
  fingernail beds (15-30 seconds)
• Rinse hands until all soap is gone
• Dry hands with a clean towel (preferably a
  disposable paper towel)
• Use towel to turn water off, if possible

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TECHNIQUE
Right palm over left dorsum and left palm over
right dorsum.
Palm to palm fingers interlaced.
Palm to palm.
Backs of fingers to opposing palms with fingers
interlocked.
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Problems of hand contamination

• Human hands have both transient resident
  microbial flora
• staff hand transmission is one of the most
  important methods of spread of hospital infection
  from patient to patient
• Hand hygiene is the most effective method for
  preventing this spread

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Benefits of hand hygiene

• Practicing good hand hygiene has been shown to
• Terminate outbreaks of diseases spread by person
  to person contact
• Reduce the spread of multi-drug resistant
  organisms
• Reduce overall infection rates
• Reduce staff illness and absenteeism
• It is the single most effective way to reduce the
  risk of spreading or acquiring infection

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Before hand washing

• Keep nails short
• Remove jacket and roll sleeves back
• Remove watches rings

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Limited resources

• No running water. Use a clean bowl of water
  changed between each use
• A drum with a drain spout (tap) can be elevated
  to serve as running water
• Frequent disruption of water. Store water in
  large receptacles whenever available
• No paper towels. Small clean towels can be used
  discarded after each use into a bag designated
  for laundering before reuse

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Hand Sanitizer Gel

• Alternative to hand washing.
• Alcohol-based gel
• Kills 99 of microorganisms
• Takes 20-30 sec. to dry
• Do not use the gel when the hands are visibly
  soiled.

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How to Use Hand Sanitizer Gel

• Apply a small amount of hand sanitizer on your
  hands. (about 2 ml)
• Rub hands together, covering all surfaces of the
  hands and fingers. Keep rubbing until hands are
  dry

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How Not to Use Hand Sanitizer Gel

• Hand sanitizer is not soap! It should not be
  washed off with water.
• Hand sanitizer should not be used on top of
  gloves.
• Do not use when hands are visibly soiled.
• Do not use hand sanitizer and wash your hands.
• Soap and water should always be your first
  choice!

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Unsafe Hand Hygiene

• Using a pair of gloves for a long time instead of
  practicing hand hygiene.
• The use of spirit to decontaminate your hands.
• The use of bleach to decontaminate your hands.
• Reusing emptied hand sanitizer bottles without
  relabeling them.

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Compliance with Hand Hygiene

• Reasons for not washing hands
• Inconvenient or no sinks
• Lack of soap or paper towels
• Too busy / No time
• Soap causing skin irritation or dryness
• Thinking the risk of transmitting disease is low
• Understaffed / Overcrowded
• Lack of knowledge about the value of hand hygiene

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Guidelines for hand washing

• Soap and sinks should be accessible.
• Alcohol based hand gel should be available at
  the entrance to the neonates room or at each
  bedside.
• Written procedures that encourage routine hand
  washing should exist.

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Take home message

• Always wash hands before and after every direct
  patient contact.
• Gloves are not an alternative to hand hygiene.
• The greatest challenge to hand hygiene is
  attitude.
• It is the single most effective way to reduce the
  risk of spreading or acquiring infection

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The end.

• THANK YOU