Clean hands are lifesavers

1
Part II
2
How do we stop the spread of microorganisms in
hospital?

• Standard Precautions
• Hand hygiene
• Additional Precautions
• Isolation
• Contact Precautions
• Equipment reprocessing
• Environmental cleaning

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What is hand hygiene?

• Hand hygiene defines several actions designed to
  decrease transient flora on the hands
• Handwashing
• Action of washing hands with an unmedicated
  detergent and water to remove dirt and loose
  transient flora to prevent cross transmission.
• Hand antisepsis
• Any action where an antiseptic solution is used
  to clean hands
• Either an antiseptic agent added to the detergent
  or
• Alcohol (waterless hand disinfection)

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Hand hygiene

• Hand hygiene is the most effective and
  inexpensive measure to prevent cross transmission
  and healthcare associated infections
• Compliance remains universally low 40
• Duration of handwashing rarely meets a minimum
  standard of 10-15 seconds

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Cost-effectiveness of hand hygiene

• The costs of hand hygiene promotion programs have
  been estimated at US1.42 per patient admitted
  and AUS2.50 per discharged patient
• Total cost of the program would be cost saving if
  less than 1 reduction in HAI was observed
• Program cost beneficial is HAI rates decreased by
  as little as 0.1

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When to perform hand hygiene

• Before and after direct patient contact
• After removing gloves
• Before handling an invasive device for patient
  care (regardless of whether or not gloves are
  used)
• After contact with body fluids or excretions,
  mucous membranes, non-intact skin, or wound
  dressings
• If moving from a contaminated body site to a
  clean body site on the same patient
• After contact with inanimate objects (including
  medical equipment) in the immediate vicinity of
  the patient

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Hand hygiene technique

• Efficacy depends on the time taken and the
  technique
• Process of handwashing has been estimated to take
  20 to 30 seconds
• The greatest reduction is achieved in the first
  15 seconds
• Rings, watches and bracelets should be removed as
  microorganisms may be harboured and protected
  from removal
• Allergic skin reactions are more likely to occur
  due to accumulation of handwash agent or glove
  powder
• Fingernails should be short, clean and healthy
• Cuticles, hands and forearms should be free of
  open lesions or breaks in skin integrity
• Hand drying
• Care of hands

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Hand hygiene technique
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Glove use

• There is strong evidence that hands must be
  washed (or cleaned) after glove removal
• Gloves do not provide complete protection against
  hand contamination
• Small perforations in the gloves (5 to 60
  puncture or tear)
• Contamination of hands on removal of gloves
• Bacterial flora from patients may be recovered
  from the hands of up to 30 of HCWs who wear
  gloves during patient contact