Hand Hygiene
Learning Objectives Identify the best ways to prevent healthcareassociated infections (HAI). Understand why the Center for Disease Control and Prevention (CDC) recommends using alcohol-based handrubs (ABHRs) over soap and water hand washing for routine hand decontamination. Identify appropriate hand hygiene practices for both soap and water hand washing and use of ABHRs.
DID YOU KNOW? Most healthcare workers THINK they know when and how to clean their hands? But research consistently shows that healthcare providers only clean their hands 40% of the time! And many do not do it the right way!!
WHAT IS GOOD HAND HYGIENE? Knowing WHEN to perform hand hygiene Choosing the CORRECT method ABHRs or washing with soap and water Doing it the right way How to rub hands How to wash hands
GERMS ARE EVERYWHERE Bacteria and viruses are everywhere. They can survive for weeks on surfaces like countertops and stethoscopes. Ties are full of microbes! Healthy skin is colonized by staph germs and cause no harm. Healthcare workers hands are the most common way of transferring germs.
Where s the Dirt? CDC studies show that the number of bacteria per square centimeter on the human body are as follows: Scalp 1,000,000 Forearm 10,000 Arm pit 500,000 Abdomen 40,000 Hands of medical personnel 40,000 to 500,000 When it comes to hand, fingernails and the surrounding areas harbor the most microorganisms.
FACTS A Healthcare Acquired Infection (HAI) is any infection occurring as a result of patient care that was not present before that care. 5% to 7% of patients in the US will get an HAI. HAIs occur mostly in hospitals but can occur in all settings including clinics. Routine cleaning hands between patient care activities prevents HAIs.
Doorknobs WHERE YOU FIND GERMS Shaking a patient s hand Taking a patient s blood pressure Covering your sneeze or cough Using the toilet Surfaces in the patient s room Medical equipment Touching a patient
WHERE YOU FIND GERMS Come into contact with blood or other body fluids, excretions, mucous membranes or nonintact skin: Giving an injection Putting in eye drops Drawing blood Dressing a patient s wound Examining a patient s mouth
TRANSMISSION Patient to Patient Organisms present on patient s skin or have shed onto inanimate objects in close proximity to the patient Germs transferred to the hands of the health care worker and can survive for several minutes on the hands. No washing or inadequate hand rub. Contaminated hands contact another patient or inanimate object that patient will contact.
YOUR 5 MOMENTS FOR HAND HYGIENE 2. Before Aseptic Task 4. After pt. contact 1. Before pt. contact 5. After contact with pt. surroundings
1. BEFORE PATIENT CONTACT Clean your hands before touching a patient. Why: To protect the patient against harmful germs carried on your hands.
Clean your hands immediately before any aseptic task. Why: 2. BEFORE CLEAN/ASEPTIC PROCEDURE To protect the patient against harmful germs, including the patient s own germs, entering his or her body.
3. AFTER BODY FLUID EXPOSURE RISK Clean your hands immediately AFTER an exposure risk to body fluids (and after glove removal). Why: To protect yourself and the health-care environment from harmful patient germs.
4. AFTER PATIENT CONTACT Clean your hands AFTER touching a patient and his/her immediate surroundings when leaving. Why: To protect yourself and the health-care environment from harmful patient germs.
5. AFTER CONTACT WITH PATIENT Clean your hands after touching any object or furniture or medical equipment in the patient s immediate surroundings. Why: SURROUNDINGS To protect yourself and the health-care environment from harmful patient germs.
SOAP OR ALCOHOL RUBS? The winner: alcohol rubs! More effective than plain or even antimicrobial soaps unless the hands are heavily soiled.
USE OF ALCOHOL RUB Apply amount to hands Be sure to work product in between fingers Rub hands together until dry Make sure hands are really dry Don t wipe the liquid off
CDC PREFERS ALCOHOL RUBS Why? Takes less time than soap and water Effectively reduces germs on the skin Less drying to the skin than hand washing (all contain skin softeners) Convenience Can be installed at the point of patient care or in pocket
WHEN TO USE SOAP AND WATER Only when your hands are dirty or visibly soiled with blood or other body fluids. After using the restroom. Before eating. Wash with soap and water for a minimum of 15 seconds; 30 seconds is best. Rinse and dry thoroughly. Use towel to turn off faucet.
GLOVES Wear when caring for patients with MRSA or Clostridium difficile or other infectious agent. Direct patient exposure: contact with blood, mucous membrane, IV insertion and removal, drawing blood, suctioning, emptying emesis basin, handling/cleaning instruments, handling waste, cleaning up spills of body fluids.
GLOVES Use of gloves does not replace the need for cleaning hands. Remove gloves and use alcohol rub. Gloves carry germs! Change gloves between patients. Change when moving from a contaminated site to a clean site.
FINGERNAILS Real or artificial can harbor harmful bacteria near and underneath them. Wear them short if you engage in patient care.
WHY WOULD YOU NOT PERFORM Some workers say: Too busy, understaffed Alcohol rub takes 15 seconds! Not needed if gloves are worn Gloves carry germs and can penetrate gloves with small tears Don t know how to use the alcohol rub learn HAND HYGIENE? Low risk at getting infected by patients Want to protect patients and staff
WHY NOT? Alcohol rubs dry and irritate the skin Maybe 10 years ago, but today ALL contain lotions! It s inconvenient. ABHR dispensers can be located anywhere and pocket size containers can be used. No one else uses them. This does not make it right. Be a role model!
YOUR ROLE Fight infections by using alcohol rubs or washing your hands. Rub it in!! Be a role model and remind coworkers. Be a Star!