1. Emerson May II Microbiology

2.  Resident Organisms-natural within the body; skin/hair follicles  Permanent flora  Reestablish themselves  Not removed by hand washing  Normally not associated with transmission of infection  Transient Organisms- acquired from patient environment  Superficial layers of skin  Temporary flora  Does not reestablish  Easily removed by hand washing  Associated with transmission of infection

3.  An infection occurring in patient during hospital which was not present upon admission  Infection acquired after discharge; and also occupational infections among health care workers  Nosocomial/hospital infection  On average a patient spends 11 days or longer in hospital if they acquire health care associated infection  HCAI are costly and one of the leading costs in hospitals r/t hospitalization

4.  Importance of hand washing  Hand washing prevents the spread of germs and bacteria  Antibiotics do not kill germs on the hands.  Hands are exposed the most and carry the most germs; then germs transmitted to eyes, mouth nose, or food then transferred into the body.  Germs hide on all areas: remotes, door knobs, faucets, and so much more.  Hand washing is a safeguard against infectious agents.

5.  Alcohol-Based Products  Gel: used in dispensers, no drip, amount is measured, individual bottles for personal use  Foam: difficult to measure accurate amount for killing germs  Rinse: may splash/drip, measurable amount  Wipe: limited effect, single-use; convenient  If not used properly alcohol-based products will not be effective in killing germs  Alcohol in the sanitizer kills 60%-70% of germs

6.  There is a place and time to use soap and water and when to use alcohol-based gels.  We need for everyone to know that germs can live on unwashed hands for hours.  Although we may be in a rush and think our hands are not soiled 99% of the time they are soiled and should be washed instead of using an alcohol-based gel.  It is important that we understand the mode of transmission

7.  Alcohol-Based Rub  Requires less time  Acts quickly to kill microorganisms  More accessible  Less irritating to skin  Can improve skin condition  Apply rub to palm of one hand  Rub hands together covering all areas hands/fingers  Rub hands together until dry  Washing With Soap/Water  Interrupts the spread of disease  Wash hands with soap/water for 20-30 seconds singing “happy birthday”  Remove any jewelry before washing  Wash hands up above wrists and rinse downward removing dirt away from body

8.  Understand why healthcare workers MUST NOT exercise poor hygiene:  Poor personal hygiene  Ear jewelry  Wear artificial/ have long nails  Why  Nails can puncture gloves  Can get caught in objects  Poor personal hygiene can be a breeding ground for microorganisms/fungi

9.  Real time location  Motion sensors when entering and leaving rooms  Monitoring hand gel/soap dispensers when entering and leaving rooms  These will give us estimate numbers of hand hygiene and show us where we need to improve  5 moments for hand hygiene  Before touching a patient  Before clean/aseptic procedure  After body fluid exposure risk  After touching a patient  After touching patient surroundings

10. Hand Hygiene in Healthcare Settings. (2015, January 8). Retrieved February 23, 2015, from http://www.cdc.gov/handhygiene/http://www.cdc.gov/handhygiene/ Adult health. (2015, January 1). Retrieved February 23, 2015, from http://www.mayoclinic.org/healthy-living/adult-health/in-depth/hand- washing/art-20046253