The 1 st Step in Infection Control is Hand Hygiene
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1 The 1 st Step in Infection Control is Hand Hygiene Presented by Leslie Canham, CDA, RDA Leslie Canham is a Certified and Registered Dental Assistant and has been in the dental field since She is authorized by the Department of Labor as an OSHA Outreach Trainer in General Industry Standards. She speaks nationally and internationally to dental societies, study clubs and organizations as well as being a moderator of the Infection Control Forum on Dentaltown.com. Leslie has authored numerous articles and continuing education courses published in dental publications. She is a member of: Organization for Safety and Asepsis Procedures, Speaking, Consulting Network, National Speakers Association, the Academy of Dental Management Consultants, American and California Dental Assistants Association, California Dental Association, California Association of Dental Assistant Teachers. Leslie is the founder of Leslie Canham and Associates providing In-Office Training, Mock inspections, Home-study courses, teleconferences, and webinars.
2 What Challenges do you have with your hands? Irritation Allergy Sore Hands Sore Thumbs Dry/Cracked Skin Contact Dermatitis & Latex Hypersensitivity Contact Dermatitis (Irritant or Allergic) Latex Hypersensitivity (Type 1-Latex Allergy) Preparations used for Hand Hygiene Plain Soap Iodine and Iodophors Alcohols Chlorhexidine Chloroxylenol Hexachlorophene Quaternary Ammonium Compounds Triclosan Other Agents Page 1
3 Efficacy of Hand Hygiene Preparations in Killing Bacteria Good Better Best Plain Soap Antimicrobial soap Alcohol-based handrub Guideline for Hand Hygiene in Health-Care Settings MMWR, vol. 51, no. RR-16. Effect of Alcohol-Based Handrubs on Skin Condition Dry Self-reported skin score Epidermal water content Healthy Healthy Dry ~ Alcohol-based handrub is less damaging to the skin ~ Boyce J, Infect Control Hosp Epidemiol 2000;21(7): Hand Drying Methods and Drying Times CDC OPRP- General information on Hand Hygiene Page 2
4 Types of Hand Hygiene Footnotes 1. Pathogenic organisms have been found on or around bar soap during and after use. Using liquid soap with hands-free controls for dispensing is preferable. 2. Transient microorganisms often acquired by health care personnel during direct contact with patients or contaminated environmental surfaces. Transient microorganisms most frequently associated with health care-associated infections and are more amenable to removal by routine hand washing than resident flora. 3. Time reported as effective in removing most transient flora from the skin. For most procedures, a vigorous, brief (at least 15 seconds) rubbing together of all surfaces of premoistened lathered hands and fingers followed by rinsing under a stream of cool or tepid water is recommended. Hands should always be dried thoroughly before donning gloves. 4. Resident flora are species of microorganisms that are always present on or in the body; not easily removed by mechanical friction; and less likely to be associated with health-careassociated infections. 5. Waterless products (e.g., alcohol-based hand rub) are especially useful when water facilities are unavailable (e.g., during dental screenings in schools) or during boil-water advisories. Alcoholbased hand rubs should not be used in the presence of visible soil or organic material. 6. Removal of all jewelry, washing as described above, holding the hands above the elbows during final rinsing, and drying the hands with sterile towels. 7. Before beginning surgical hand scrub, remove all arm jewelry and any hand jewelry that may make donning gloves more difficult, cause gloves to tear more readily, or interfere with glove usage (e.g., ability to wear the correct-sized glove or altered glove integrity). 8. Persistent activity. Prolonged or extended activity that prevents or inhibits proliferation or survival of microorganisms after application of a product. Previously, this property was sometimes terms residual activity. Reference Page 3
5 Fingernails, Artificial Nails and Jewelry Keep your natural fingernails short to about ¼ inch Artificial Nails harbor gram negative bacteria Jewelry Physiology of Normal Skin The primary function of skin is to Reduce water loss Provide protection Act as a permeable barrier to the environment Skin Care Lotions keep your hands soft and moisturized They should: Absorb quickly into skin Be plain-no fragrance Be non greasy Be Petroleum free (compatible with gloves) and have sufficient amounts of emollients and moisturizers Page 4
6 Gloves Latex Vinyl Nitrile Surgical Gloves Over gloves Utility Gloves Fitted Gloves Ambidextrous Gloves Hand Hygiene Resources Hand Hygiene Guidelines, Hand Hygiene in Dental Settings, Posters, Videos Karen Burk, Glove Expert SmartPractice ext 270 Hu-Friedy, Hand Essentials Hand Care Line Page 5
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