Presentation on theme: "Hand Hygiene In-Service for Staff"— Presentation transcript:
1Hand Hygiene In-Service for Staff This slide set has been adapted from a CDC training presentation entitled “Hand Hygiene in Healthcare Settings-Core”. The CDC slide set was based on the CDC Guideline for Hand Hygiene in Health-care Settings published in 2002.Slides are tailored to assisted living facilities and nursing homes as much as possible.
2What is Hand Hygiene? Hand hygiene involves the following: Hand washing:washing hands with soap and waterAlcohol-based hand rub:rubbing hands with an alcohol-containing preparationHand hygiene is a general term that applies to either handwashing, using an alcohol-based handrub, or using antiseptic handwash.Handwashing refers to washing hands with soap and water. Handwashing with soap and water remains a good strategy for hand hygiene in non-healthcare settings and is recommended by CDC and other experts.Alcohol-based handrub refers to the alcohol-containing preparation applied to the hands to reduce the number of microorganisms % alcohol is best.Hand hygiene can also involve using an antiseptic handwash or other detergent to cleanse hands.Guideline for Hand Hygiene in Health-Care Settings. MMWR 2002; vol. 51, no. RR-16.
3Why Don’t We Wash Our Hands Why Don’t We Wash Our Hands? Self-Reported Factors for Poor Adherence with Hand HygieneSkin irritation and drynessSinks are inconveniently located/lack of sinksLack of soap and paper towelsToo busy/insufficient timeUnderstaffing/overcrowdingResident needs take priorityLow risk of acquiring infection from residentsHealthcare workers have reported several factors that may negatively impact their adherence with recommended practices including; handwashing agents cause irritation and dryness, sinks are inconveniently located, lack of soap and paper towels, not enough time, understaffing or overcrowding, and patient needs taking priority.Lack of knowledge of guidelines/protocols, forgetfulness, and disagreement with the recommendations were also self reported factors for poor adherence with hand hygiene.Perceived barriers to hand hygiene are linked to the institution and HCWs colleagues. Therefore, both institutional and small-group dynamics need to be considered when implementing a system change to secure and improve HCWs hand hygiene practice.Adapted from Pittet D, Infect Control Hosp Epidemiol 2000;21:
4Clean Hands Save LivesClean hands are the most important factor in preventing the spread of disease and antibiotic resistance in settings across the continuum of health care.Hand hygiene:Promotes resident safety and prevents infectionsReduces the incidence of healthcare-associated infectionsClean hands are the single most important factor in preventing the spread of disease and antibiotic resistance in settings across the continuum of care from home health and assisted living to nursing facilities and acute care hospitals.More widespread use of hand hygiene products that improve adherence to recommended hand hygiene practices will promote patient/resident safety and prevent infections.Hand hygiene reduces the incidence of healthcare associated infections.CDC estimates that each year nearly 2 million patients in the United States get an infection in hospitals, and about 90,000 of these patients die as a result of their infection.
5Hand Hygiene: How and When If hands are visibly dirty, contaminated, or soiled, wash with soap and water.After using the restroomBefore eating or preparing foodIf hands are not visibly soiled, use an alcohol-based hand rub for routinely decontaminating hands.When hands are visibly dirty, contaminated, or soiled, wash with soap and water. This includes after using the restroom and before eating or preparing food.If hands are not visibly soiled, use an alcohol-based handrub for routinely decontaminating hands.Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
6When to Perform Hand Hygiene Before and after:Contact with a residentTreating a cut or wound (Ex: changing dressings or bandages)Before:Putting on glovesPreparing or eating foodTouching your eyes, nose, or mouthHandling/administering medicationInsertion of invasive devicesHand hygiene is indicated before and after: contact with a patient/resident and changing wound dressings or bandages (treating a cut or wound)Gloves should be used when a HCW has potential for contact with blood or other body fluids in accordance with standard precautionsBe sure to perform hand hygiene before preparing or eating food, touching one’s eyes, nose, or mouth, administering medication, or inserting invasive devices such as catheters (regardless of glove use)NOTE: Hand hygiene before handling medication is a recommendation of WHOGuideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no. RR-16.
7When to Perform Hand Hygiene After:Contact with blood, body fluids, mucous membranes, secretions, excretions, or non-intact skinRemoving glovesTouching surfaces or objects in the resident’s environment that may be contaminated (bed rails, bedside tables, light switches, etc.)Handling garbageUsing the restroomBlowing your nose, coughing, or sneezingHand hygiene is also indicated after contact with a patient/resident’s blood, body fluids, mucous membranes, secretions (except sweat), excretions, or non-intact skin, after removing gloves, after touching surfaces or objects in the resident’s environment that may be contaminated with bacteria or viruses, such as bed rails, bedside tables, light switches, and resident care equipment, and after handling garbage.All persons, not just care providers, should always perform hand hygiene after using the rest room and blowing their nose, coughing, or sneezing.
8Efficacy of Hand Hygiene Preparations in Killing Bacteria GoodBetterBestPlain soap is good at reducing bacterial counts but antimicrobial soap is better, and alcohol-based handrubs are the best.Alcohol-based handrubs are also less damaging to the skin than soap and water. The next slide shows some data on the effect of soap and water on the hands versus alcohol-based handrub.Plain soapAntimicrobial soapAlcohol-based hand rub
9Self-reported skin score Effect of Alcohol-Based Hand Rubs on Skin ConditionSelf-reported skin scoreDryIn the graph, the blue bar shows self-reported skin health scores for persons using soap and water, and persons using alcohol-based handrubs are depicted by the orange bar. Self-reported studies indicate participants using soap and water reported a significant increase in dryness, cracking, and irritation after 2 weeks, whereas those that used the alcohol-based handrub reported improvement in skin dryness.Epidermal water content studies report the same types of results showing that the skin water content decreased for those that used soap and water (resulting in dryer skin) as compared with those who used an alcohol-based handrub.Alcohol-based handrubs are less damaging to the skin than soap and water.HealthyBoyce J, Infect Control Hosp Epidemiol 2000;21(7):
10Benefits of Alcohol-Based Hand Rubs Improve skin conditionRequire less timeMore accessible than sinksReduce bacterial counts on handsMore effective for standard hand washing than soapAlcohol-based handrubs provide several advantages compared with handwashing with soap and water, because provide improve skin condition and they not only require less time, they also act faster. In addition, alcohol-based handrubs are more effective for standard handwashing than soap, are more accessible than sinks, are the most efficacious agents for reducing the number of bacteria on the hands of healthcare workers.
11Recommended Hand Hygiene Technique Hand rubsApply to palm of one hand, rub hands together covering all surfaces until dry.Manufacturer will instruct how much to use.Hand washingWet hands with water, apply soap, rub hands together for at least 15 seconds.Rinse and dry with disposable towel.Use towel to turn off faucet.These recommendations will improve hand hygiene practices of HCWs and reduce transmission of pathogenic microorganisms to patients and personnel in healthcare settings.When decontaminating hands with an alcohol-based handrub, apply product to palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry.When washing hands with soap and water, wet hands first with water, apply the amount of soap recommended by the manufacturer, and rub hands together for at least 15 seconds, covering all surfaces of the hands and fingers. Rinse hands with water, dry thoroughly with a disposable towel, and use the towel to turn off the faucet.Guideline for Hand Hygiene in Health-Care Settings. MMWR 2002; vol. 51, no. RR-16.
12GlovingWear gloves when contact with blood or other potentially infectious materials is possible.Remove gloves after caring for a resident.Do not wear the same pair of gloves for the care of more than one person.Do not wash gloves.Wearing gloves reduces the risk of healthcare workers acquiring infections from patients/residents, prevents pathogens from being transmitted from healthcare workers to patients/residents, and reduces contamination of the hands of healthcare workers by pathogens that can be transmitted from one person to another.Gloves should be used when HCWs have contact with blood or other body fluids.Gloves should be removed after caring for a patient.The same pair of gloves should not be worn for the care of more than one patient.Gloves should not be washed or reused.Guideline for Hand Hygiene in Health-Care Settings. MMWR 2002; vol. 51, no. RR-16.
13Fingernails and Artificial Nails Natural nail tips should be kept to ¼ inch in length.Artificial nails should not be worn when having direct contact with high-risk residents.Nail length is important because even after careful handwashing, HCWs often harbor substantial numbers of potential pathogens in the subungual spaces.Numerous studies have documented that subungual areas of the hand harbor high concentrations of bacteria, most frequently coagulase-negative staphylococci, gram-negative rods (including Pseudomonas spp.), corynebacteria, and yeasts.Natural nail tips should be kept to ¼ inch in length.A growing body of evidence suggests that wearing artificial nails may contribute to transmission of certain healthcare-associated pathogens. Healthcare workers who wear artificial nails are more likely to harbor gram-negative pathogens on their fingertips than are those who have natural nails, both before and after handwashing. Therefore, artificial nails should not be worn when having direct contact with high risk patients. In hospitals, these would include persons who work in intensive care or operating rooms.Guideline for Hand Hygiene in Health-Care Settings. MMWR 2002; vol. 51, no. RR-16.