1. Clean Hands Across Newfoundland and Labrador
Hand Hygiene

2. Objectives
To provide a consistent provincial approach to hand hygiene education
Components include:
Hand hygiene guidelines
Hand hygiene education module
Hand hygiene auditor education

3. Hand Hygiene: Key Concepts
During healthcare delivery, there are four moments when it is essential that you perform hand hygiene.
It is essential that everyone perform hand hygiene using the appropriate technique and time duration in order for it to be effective.
Alcohol-based hand rub is the preferred method of Hand Hygiene

4. Hand Hygiene: WHY ?
Hand hygiene is the single most effective way to prevent the transmission of healthcare-associated infections.
Good hand hygiene saves lives and reduces the strain on our healthcare system. 1
It takes less than one minute to properly wash hands using soap and water and less than 30 seconds to properly clean hands with alcohol-based hand-rub. Both methods are effective.
1 Roth, Virginia, MD, FRCPC “Hands that harm, hands that heal” November 2006 PowerPoint presentation, slide 31

5. Hand Hygiene: Importance
Did you know that
As a health care provider (HCP) you are also a vehicle for carrying around infectious organisms
80% of staff who dressed MRSA infected wounds carried the organism on their hands for 3 hours afterwards
Within ½ hour of contact with the environment of a patient with Clostridium difficile, 60% of the hands of staff were contaminated without even touching the patient
Performing hand hygiene with soap and water in these cases virtually eradicated these organisms!
Stone, S.P. JR Soc Medicine 2001: 94(6); Cited in Mitka, M. JAMA 2009: 302(17) reprinted.

6. Hand Hygiene: Who ? Who is a health care provider?
A health care provider is a person delivering care to a client, patient or resident. This may include a volunteer.
Staff –people conducting activities in a setting where health care is provided, including but not limited to health care providers.

7. Hand Hygiene: When The Four Moments of Hand Hygiene
have been identified as critical to the prevention of transmission of infections during healthcare delivery.
Ontario’s Ministry of Health adapted this WHO’s 5 Moments of Hand Hygiene

8. Four Moments of Hand Hygiene
Before patient /
patient
environment
contact
2. Before
aseptic
procedure
4. After patient/patient
environment contact
3. After body
fluid
Exposure/
risk

9. Hand Hygiene: Where Hand Hygiene must be performed at Point of Care
Point of Care – the place where three elements come together
The patient
The healthcare provider
The care or treatment involving contact with the patient or his/her surroundings/environment

10. Definition of Patient’s Environment
Single room – everything in the patient’s room
Multi-bed room –
everything in
immediate proximity
to the patient

11. Hand Hygiene: Time
Optimal hand hygiene using an alcohol-based hand rub takes seconds
Minimum time is 15 seconds
Optimal hand hygiene using soap and water takes 40 to 60 seconds
Both are effective methods
Alcohol-based hand rub is the preferred method of Hand Hygiene

12. To effectively reduce the growth of germs on hands, handrubbing must be performed by following all steps illustrated on the left. Please click here to watch the how to hand rub video.

13. To effectively reduce the
growth of pathogens on hands, handwashing should be performed by following all steps illustrated on the left. Please click here to watch the how to hand wash video.

14. Hand Hygiene: Obstacles
Too busy
High workload and understaffing
Patient needs perceived as priority
Interference with worker/patient relation
It is essential that you make time
Skin irritation
Use lotions & hand rub appropriately
Glove use
Not a substitute for hand hygiene
Not a spontaneous habit
Hand Hygiene needs to become as spontaneous as using aseptic technique and all other safety strategies

15. Effective Hand Hygiene
Nails must be kept clean and short
Nail polish must not be worn
Artificial nails or nail enhancements must not be worn
Rings are not worn during Hand Hygiene
Arm jewelry, including watches and medical alert bracelets, must be removed or pushed up

16. Effective Hand Hygiene
Gloves do not replace the practice of hand hygiene
Let hands dry completely before donning gloves
Wear gloves only when indicated
Avoid hand washing immediately before or after using an Alcohol Based Hand Rub
Use warm water
Use hand lotions and creams approved by your RHA
Use alternative products if allergic