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Hand Hygiene.pdf
- 1. Core Concepts forHand Hygiene: Clean Hands for Healthcare Personnel 1
- 2. Learning Objectives 2 After thispresentation the students will be able to: • Define hand hygiene • Outline the purpose / importance of effective hand hygiene for the protection of healthcare personnel and patients • Describe proper hand hygiene techniques, including when various techniques should be used
- 3. Definition of HandHygiene 3 What is hand hygiene? • Hand hygiene is a way of cleaning one's hands that substantially reduces potential pathogens (harmful microorganisms) on the hands. • Hand hygiene is considered a primary measure for reducing the risk of transmitting infection among patients and health care personnel.
- 4. Why is HandHygiene Important? 1 out of every 25 patients has a healthcare-associated infection • The microbes that cause healthcare-associated infections (HAIs) can be transmitted on the hands of healthcare personnel • Hand hygiene is one of the MOST important ways to prevent the spread of infection • Too often healthcare personnel do not clean their hands – In fact, missed opportunities for hand hygiene can be as high as 50% (Chassin MR, Jt Comm J Qual Patient Saf, 2015; Yanke E, Am J Infect Control, 2015; Magill SS, N Engl J Med, 2014) 4
- 5. Environmental Surfaces Can LookClean but… • Bacteria can survive for days on patient care equipment and other surfaces like bed rails, IV pumps, etc. • It is important to use hand hygiene after touching these surfaces and at exit, even if you only touched environmental surfaces Boyce JM, Am J Infect Control, 2002; WHO Guidelines on Hand Hygiene in Health Care, WHO, 2009 5
- 6. Hands Make Multidrug-ResistantOrganisms (MDRO Other Microbes Mobile (Image from CDC, Vital Signs: MMWR, 2016) 6
- 7. (Boyce JM, AmJ Infect Control, 2002; WHO Guidelines on Hand Hygiene in Health Care, WHO, 2009) 1. Before touching a patient 2. Before providing a clean/aseptic procedure 3. After direct contact with body fluid 4. After touching a patient 5. After touching surfaces around a patient 7 When Should You Clean Your Hands?
- 9. Partnering With Patientsfor Hand Hygiene • Healthcare personnel should encourage patients, families and visitors to clean their hands • Moments for patients to perform hand hygiene are: – Before or after touching invasive devices or bandages • e.g. IV, surgical site, feeding tube – Before eating – After using the restroom or handling a bedpan – When entering or leaving their room 9
- 10. Encourage patients tonot be afraid to use their voice - that it’s ok to ask their healthcare provider questions, such as: • “I didn’t see you clean your hands when you came in, would you mind cleaning them again before you examine me?” • “I’m worried about germs spreading in the hospital. Will you please clean your hands once more before you start my treatment?” 10 Patient Education: Empowering Patients to Speak Up
- 11. Hand Hygiene Methods Handhygiene applies to use of either alcohol-based hand rub or the use of soap and water. Specific methods include: • Alcohol-based hand rub – Rubbing hands with an alcohol-containing hand hygiene product • Handwashing – Washing hands with plain soap and water • Antiseptic hand wash – Washing hands with water and soap or other detergents containing an antiseptic agent • Surgical hand hygiene/antisepsis – Handwashing with antiseptic soap or using an alcohol-based hand rub before providing surgery 11
- 12. Which Method KillsBacteria Better? (Boyce JM, Am J Infect Control, 2002; WHO Guidelines on Hand Hygiene in Health Care, WHO, 2009) 12
- 13. What Are theBenefits of Alcohol-Based hand rubs • Requires less time • More effective than washing with soap and water • More accessible than sinks • Reduces bacterial counts on hands • Improves skin condition (Boyce JM, Am J Infect Control, 2002; WHO Guidelines on Hand Hygiene in Health Care, WHO, 2009) 13
- 14. A Picture ofthe Power of Hand Hygiene • Panel A (left): Culture of healthcare personnel’s hand following ungloved abdominal exam of a patient – colonized with methicillin-resistant S. aureus (MRSA) • Panel B (right): Same personnel’s hand after application of alcohol-based hand rub (Donskey CJ, N Engl J Med, 2009) 14
- 15. Choosing the RightAlcohol-Based Hand Rub and Using the Correct Technique Hand Rub (foam or gel) 1. Select an alcohol-based hand rub that is between 62% and 90% alcohol. 2. Apply to palm of one hand (the amount used depends on specific hand rub product approx. 5ml) 3. Rub hands together, covering all surfaces, focusing in particular on the fingertips, fingernails, and underneath fingernails, until dry (Image from Healthcare Providers. Clean Hands Count Campaign, CDC) 15
- 16. Hand Washing Technique HandWashing (soap and water) 1. Wet hands with water 2. Apply soap 3. Rub hands together for at least 40-60 seconds including every step & covering all surfaces, focusing on fingertips and underneath fingernails 4. Rinse under running water and dry with disposable towel 5. Use the towel to turn off the faucet 16
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- 19. Myth Busters AroundHand Hygiene (Healthcare Providers. Clean Hands Count Campaign, CDC Website http://www.cdc.gov/handhygiene/providers/index.html) Hand hygiene method for patient with Clostridium difficile infection? Step 1. Put on gloves! Step 2. Consider RUB IN (using hand rub)…& WASH OUT (soap) 19
- 20. Where are themicrobes...? Make sure you clean under nails and fingertips 20 Myth Busters Around Hand Hygiene (Healthcare Providers. Clean Hands Count Campaign, CDC Website, http://www.cdc.gov/handhygiene/providers/index.html)
- 21. Myth Busters AroundHand Hygiene 21 Use enough hand hygiene product Using gloves does not mean hand hygiene can be skipped! (Healthcare Providers. Clean Hands Count Campaign, CDC Website, http://www.cdc.gov/handhygiene/providers/index.html)
- 22. References 22 • • • • • • • • • • • Boyce JM,Pittet D. Healthcare Infection Control Practices Advisory Committee: HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Guideline for hand hygiene in health-care settings: Recommendations of the Healthcare InfectionControl Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA handhygiene task force. Am J Infection Control2002; 30(8):S1-S46. • Chassin MR, Mayer C, Nether K. Improving hand hygiene at eight hospitals in the United States by targetingspecific causes of noncompliance.Jt Comm J QualPatientSaf. 2015; 41(1):4-12. Clean Hands Count for Healthcare Providers. Centers for Disease Control and Prevention. http://www.cdc.gov/handhygiene/providers/index.html Donskey CJ, Eckstein BC. Images in clinicalmedicine. The hands give it away. N Engl J Med. 2009; 360(3):e3. FitzGeraldG, Moore G, Wilson AP. Hand hygiene after touching a patient's surroundings:the opportunities most commonly missed. J Hosp Infect. 2013; 84(1):27-31. Guidelinefor Hand Hygiene inHealthcare Settings. Center for DiseaseControl and Prevention. https://www.cdc.gov/handhygiene/providers/guideline.html Magill SS,Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care–associated infections. N Engl J Med. 2014; 370(13):1198-208. Patients and Visitors. CleanHands Count. Centers for Disease Control and Prevention, CDC. Available at https://www.cdc.gov/handhygiene/pdfs/patient-factsheet-508.pdf Pittet D, Allegranzi B, Sax H, et al. Evidence-based model for hand transmissionduring patient care and the role of improved practices. Lancet Infect Dis. 2006; 6(10):641-52. • Sunkesula VCK, Knighton S, Zabarsky TF, et al. Four Moments for Patient Hand Hygiene: A Patient-Centered,Provider-Facilitated Model to Improve PatientHand Hygiene. Infect. ControlHosp. Epidemiol. 2015; 36:986–989. Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals— United States. Centers for Disease Control and Prevention. MMWR 2016;65:235-41. WHO Guidelines on Hand Hygiene in Health Care. World Health Organization(WHO). Published2009. Available at http://www.who.int/gpsc/5may/tools/9789241597906/en/ Yanke E, Zellmer C, Van Hoof S, et al. Understanding the current state of infection prevention to prevent Clostridiumdifficile infection: a human factors and systems engineeringapproach. Am J Infect Control. 2015; 43(3):241-7. https://www.cdc.gov/handhygiene/providers/guideline.html
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