1. Hand Hygiene for Clinical Staff
Infection Prevention & Control
July 2012

2. Objectives To understand the 4 moments for hand hygiene
To understand the two environments for hand hygiene and the impact on transmission of organisms
To identify areas for improving hand hygiene within your clinical practice

3. Ask Yourself…….. How good is your hand hygiene?
Where have your hands been?
Do you clean your hands between every patient?
Are there opportunities for you to improve your hand hygiene?

4. Did You Know?
Most health care providers believe they are already practicing good hand hygiene, but research has shown that hand hygiene compliance is:
<40%

5. Two Different Environments
Healthcare Environment
Patient Environment
Everything outside the patient’s immediate environment
In a single room, this is outside the room. In a multiple room, this is everything outside the patient’s bed area
The patient’s immediate area

6. Transmission of Organisms
Health care providers move from patient to patient and room to room to provide care
This movement provides many opportunities for the transmission of organisms to occur
It only takes ONE missed hand hygiene opportunity to spread an infection

7. When should hand hygiene be performed?
Before putting on gloves and after taking gloves off
Before preparing, handling, serving or eating food
After personal body functions
When unsure if hands are clean because germs are not visible
THE 4 MOMENTS FOR HAND HYGIENE are some essential moments in health care where the risk of transmission is greatest and hand hygiene must always be performed

8. The 4 Moments for Hand Hygiene
2. Before aseptic procedure
1. Before contact with the patient/patient environment
4. After contact with the patient/patient environment
3. After body fluid exposure

9. The 4 Moments for Hand Hygiene
Examples include:
1. Before contact with the patient/patient environment
Before shaking hands
Before taking blood pressure, pulse or chest auscultation
Helping to move or bath a patient
Before adjusting an IV

10. The 4 Moments for Hand Hygiene
2. Before Aseptic Procedure
Examples Include:
Oral/dental care, giving eye drops, secretion aspiration
Skin lesion care, wound dressing, injection
Catheter insertion
Preparing of medication or dressing sets

11. The 4 Moments for Hand Hygiene
3. After Body Fluid Exposure
Examples Include:
Secretion aspiration, oral/dental care
Skin lesion care, wound dressing, injection
Drawing any fluid sample
Cleaning up urine/feces/vomit, handling waste (bandages, incontinence pads)
Emptying catheter

12. The 4 Moments for Hand Hygiene
4. After contact with patient/patient environment
Examples Include:
After shaking hands
Moving patient, bathing patient
Taking pulse, blood pressure, chest auscultation, abdominal palapation
Changing bed linens
Holding a bed rail
Clearing the bedside table
Touching monitor

13. Where are the opportunities for hand hygiene?
You enter a ward room, the patient in bed 3 asks for help out of bed and upon leaving the room patient in bed 1 asks you to check her IV site.
How many moments for hand hygiene in this example?
Before you enter the ward room
After contact with the patient in bed 3 & before contact with the patient in bed 1
After contact with the patient in bed 1
3 Opportunities

14. Where are the opportunities for hand hygiene?
You enter a room, take the patient’s vital signs, change a dressing on the patient’s foot and then set the patient up for lunch before exiting the room.
How many moments for hand hygiene in this example?
Before you enter the room
Before starting the dressing change
After the dressing change
Upon exiting the room
4 Opportunities

15. Is this Okay? Wear gloves for as short a time as possible
Do not walk from room to room or common areas of the hospital while wearing gloves
Hands are often contaminated in the process of glove removal
Gloves do not replace the need to perform hand hygiene
Always perform hand hygiene before putting on gloves and after removing gloves

16. Hand Hygiene Reminders
Keep nails short and clean
Do not wear artificial nails
Remove chipped nail polish
Remove hand jewellery
Clean hands for a minimum of 15 seconds
Apply lotion frequently
Notify occupational health if you develop skin irritation due to hand hygiene