HAND HYGIENE. It s Everybody's Business. The Victorian Department of Human Services & Grampians Region Infection Control Group

Transcription

1 HAND HYGIENE It s Everybody's Business The Victorian Department of Human Services & Grampians Region Infection Control Group

2 How Germs Are Transmitted From Health Canada, Infection Control Guidelines 2000

3 Transmission Of Germs Germs can spread by touching: Patients Shared patient equipment IV lines and devices Bed linen and patient furniture Etc...

4 Transmission Of Germs Many objects can transmit microbes but carer s hands are the most common cause of infection in hospitals

5 Why Hand Hygiene? To protect the patient against harmful germs carried on your hands To protect the patient against harmful germs, including their own, from entering his/her body during a procedure To protect yourself and the environment from harmful patient germs

6 Protect Your Patients Poor hand hygiene = Hospital acquired infections

7 Hand Hygiene Refers To: Hand washing using soap/skin cleanser Decontamination using alcohol hand rub Decontamination using 4% Chlorhexidine

8 A MOMENT is when there is a perceived or actual risk of pathogen (germ) transmission from on surface to another via the hands.

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11 Moment 1 Shaking hands Assisting with mobilisation Repositioning in bed Bathing a patient Taking pulse, BP, O 2 saturation Applying ECG electrodes, O 2 mask Putting on glasses, hearing aids, Etc.

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13 Moment 2 Venipuncture, arterial blood gases, blood glucose level IV medication prep and administration, Wound dressings Handling tablets/capsules, eye drops, PEG tubes, NG tubes Insertion of/contact with invasive devices Contact with mucus membranes or non-intact skin Etc..

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15 Moment 3 After contact with body fluids Including after removing gloves When moving from a contaminated body site to a clean body site After any procedure listed in Moment 2

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17 Moment 4 After patient contact, where contact is not related to a procedure listed in Moment 2

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19 Moment 5 Bed, bedside locker, table, chair, IV pole Call button, TV remote, light switches Changing bed linen Contact with patients personal belongings books, clothing, toys, walking frames etc. Bedside chart Bedside curtains

20 RECOMMENDATIONS INDICATIONS FOR HAND WASHING AND HAND ANTISEPSIS WHO guidelines on Hand Hygiene in Healthcare (Advanced Draft): A Summary (2005)

21 Soap and Water Wash hands with soap and water when: Visibly dirty or soiled with blood or other body fluids If exposure to potential spore-forming organisms is strongly suspected or proven Or After using the rest room (suggested)

22 Alcohol-based hand rub Preferably use AHR for routine hand antisepsis in all other clinical situations if hands are not visibly soiled (Alternatively wash hands with soap and water)

23 Perform Hand Hygiene 1. Before and after direct patient contact 2. After removing gloves 3. Before handling invasive devices 4. After contact with body fluids, mucous membranes, non intact skin & wound dressings

24 Perform Hand Hygiene Contd 5. If moving from contaminated to clean body site 6. After contact with inanimate objects in immediate vicinity of patient 7. Before handling medications or preparing food

25 Alcohol Hand Rubs Benefits: Require less time More accessible than sinks Self drying Causes less skin irritations and dryness

26 Alcohol Hand Rubs Kills bacteria on hands more readily More effective than soap & water Chlorhexidine combined with alcohol provides a longer lasting killing effect

27 Use of Alcohol Hand Rubs Increased compliance with hand hygiene Decrease in MRSA infections when used before and after every patient contact Quick and easy hand decontamination

28 Correct Application Austin Health Rub entire surface of hand for at least 15 seconds Don't forget areas around and under your fingernails

29 Where to Place Alcohol Rubs On the foot of all patients beds Conveniently attached to mobile equipment IV trolleys, dressing trolleys, medication trolleys In high use areas Nurses stations Patient bays Examination rooms Access for public; near entrance, lifts, cafeteria (To prevent splashes in eyes avoid placing at eye level e.g. head of bed)

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31 Glove Use Single use items only do not reuse Change gloves when moving between "dirty" and "clean" body sites They should not be washed with soap and water or decontaminated with hand rubs Always clean hands after removing or changing gloves AHR or soap & water

32 The Glamour Girls! Artificial nails and chipped nail polish pose an infection risk since they result in increased hand contamination Rings of any type are associated with a 10- fold increase in the number of bacteria on health care worker's hands Avoid wearing artificial nails and nail polish to work Remove rings prior to work Keep nails neatly clipped

33 Hand Care Hands that are chaffed and cracked can lead to increase bacteria carriage Use of a hospital-supplied hand moisturiser 3-4 times per day will help prevent drying Do not use perfumed hand moisturisers, as they may be inactivated by the ALCOHOL HAND RUBS and cause the hands to become dry. Only use moisturisers supplied by your hospital.

34 References: My five moments for hand hygiene : a user-centred design approach to understand, train, monitor and report hand hygiene. H. Sax, B. Allergranzi, I. Uckay, E. Larson, J. Boyce, D. Pittet. Journal of Hospital Infection (2007) 67, 9-21 BENDIGO HEALTH INFECTION & CONTROL UNIT. Loddon Mallee Regional Rollout. Project Officer- M Jodoin VQC HAND HYGIENE PROGRAM. GENERIC ALCOHOL HAND RUB Learning Package April 2006 Hand Hygiene Victoria. 5 Moments of Hand Hygiene Manual. April Quality and Safety Programs Unit, Statewide Quality Branch, Department of Human Services Victoria